Department of Ophthalmology, Faculty of Medicine, Uludag University, Bursa, Turkey.
Mustafa Kemalpaşa State Hospital, Department of Ophthalmology, Bursa, Turkey.
Indian J Ophthalmol. 2019 Apr;67(4):505-508. doi: 10.4103/ijo.IJO_1007_18.
To evaluate the success, safety, and complication rates of gonioscopy-assisted transluminal trabeculotomy (GATT) combined with cataract surgery.
A retrospective study was conducted for 32 patients who underwent GATT combined with phacoemulsification and intraocular lens implantation. Patients with primary open-angle glaucoma were enrolled. The primary outcome measures were visual acuity, intraocular pressure (IOP), the number of antiglaucoma medications used, and complications.
The average preoperative visual acuity of the patients was logMAR 1.57 ± 1.2, and the average postoperative visual acuity was logMAR 0.39 ± 0.38. A significant increase in visual acuity was observed post-surgery (P < 0.05). The average preoperative IOP was 34.2 ± 10.6 mmHg. In the 3 postoperative month, the average IOP was 10.5 ± 2.2 mmHg, and in the 6 postoperative month, the average IOP was 11.2 ± 2.4 mmHg. In all postoperative follow-ups, IOP was significantly lower than that during the preoperative period (P < 0.05). A decrease of 2.7 ± 0.6 on average was detected in the number of glaucoma medications used in the postoperative period compared to the preoperative period, and the average decrease in the number of active ingredients post-surgery was 3.5 ± 0.8. The most frequent complication was hyphaema (31.2%). In only one patient (3.1%), the surgery was considered to have failed due to the development of deep hypotony.
Performing GATT in the same session as cataract surgery does not reduce the efficacy of GATT, yet this procedure reduces the incidence of the most frequent complication of GATT, i.e. hyphaema. Therefore, in convenient cases, combined surgery can safely be performed.
评估青光眼阀辅助经巩膜隧道小梁切开术（GATT）联合白内障手术的成功率、安全性和并发症发生率。
对 32 例行 GATT 联合超声乳化白内障吸除术和人工晶状体植入术的患者进行回顾性研究。纳入原发性开角型青光眼患者。主要观察指标为视力、眼压（IOP）、抗青光眼药物使用数量及并发症。
患者术前平均视力为 logMAR1.57±1.2，术后平均视力为 logMAR0.39±0.38。术后视力明显提高（P<0.05）。术前平均 IOP 为 34.2±10.6mmHg。术后 3 个月平均 IOP 为 10.5±2.2mmHg，术后 6 个月平均 IOP 为 11.2±2.4mmHg。所有术后随访时 IOP 均明显低于术前（P<0.05）。与术前相比，术后平均青光眼药物使用数量减少了 2.7±0.6 种，术后平均活性成分减少了 3.5±0.8 种。最常见的并发症是前房积血（31.2%）。仅 1 例（3.1%）患者因发生深度低眼压而认为手术失败。
在白内障手术同期行 GATT 并不会降低 GATT 的疗效，但该术式降低了 GATT 最常见的并发症，即前房积血的发生率。因此，在方便的情况下，联合手术可以安全进行。
