Cubuk Mehmet Ozgur, Filik Armagan, Ucgul Ahmet Yucel, Gungel Hulya
Department of Ophthalmology, Istanbul Training and Research Hospital, Istanbul, Turkey.
Department of Ophthalmology, Agrı Patnos State Hospital, Agrı, Turkey.
Int Ophthalmol. 2023 Jan;43(1):105-112. doi: 10.1007/s10792-022-02392-5. Epub 2022 Jul 6.
To evaluate the effect of Gonioscopy-assisted transluminal trabeculotomy (GATT) on macular thickness and to compare the combined GATT and cataract extraction (CE) with GATT surgery alone regarding macular thickness.
A retrospective, comparative study was designed. The patients who underwent GATT or combined GATT and CE with preoperative and regular postoperative spectral domain optic coherence tomography analysis (SD-OCT) were included. The macula was visualized in a 5 × 5 mm area by SD-OCT using MM5 mode. Two different groups were defined as follows: group 1 enrolled patients who underwent GATT alone, and group 2 enrolled patients who underwent combined GATT and CE. Pre- and postoperative macular thickness measurements by performing intragroup analysis and comparing group 1 with group 2 with regard to change in macular thickness were assessed.
Fifty-four eyes fulfilled the inclusion criteria and were enrolled in this study, (Group 1 = 29 eyes, Group 2 = 25 eyes). The mean thicknesses of central macula (CM), superior inner macula (SIM), and nasal inner macula (NIM) significantly increased 1 month after GATT alone (p < 0.05). This difference became statistically insignificant at 3rd month after the surgery, (p > 0.05). The mean thicknesses of SIM, temporal inner macula (TIM), NIM, superior outer macula (SOM), inferior outer macula (IOM), and temporal outer macula (TOM) showed a significant increase 1 month after combined GATT and CE, (p < 0.05), which return its preoperative levels 3 months after the surgery (p > 0.05). There was no significant difference between group 1 and group 2 with regard to change in macular thickness at each time points, (p > 0.05). Postoperative clinically significant CME was observed in one patient who underwent GATT alone (p = 0.351).
GATT can be a safe procedure with minimal and transient adverse effect on macular thickness and structure. Performing GATT together with CE caused no additional increase in the risk of macular thickening.
评估房角镜辅助小梁切开术（GATT）对黄斑厚度的影响，并比较GATT联合白内障摘除术（CE）与单纯GATT手术在黄斑厚度方面的差异。
设计一项回顾性比较研究。纳入术前及术后定期行光谱域光学相干断层扫描分析（SD-OCT）的接受GATT或GATT联合CE手术的患者。使用MM5模式通过SD-OCT在5×5mm区域观察黄斑。定义两个不同的组如下：第1组纳入仅接受GATT手术的患者，第2组纳入接受GATT联合CE手术的患者。通过进行组内分析评估术前和术后黄斑厚度测量值，并比较第1组和第2组在黄斑厚度变化方面的差异。
54只眼符合纳入标准并纳入本研究（第1组 = 29只眼，第2组 = 25只眼）。单纯GATT术后1个月，中心黄斑（CM）、黄斑上内侧（SIM）和黄斑鼻内侧（NIM）的平均厚度显著增加（p < 0.05）。术后第3个月，这种差异无统计学意义（p > 0.05）。GATT联合CE术后1个月，SIM、黄斑颞内侧（TIM）、NIM、黄斑上外侧（SOM）、黄斑下外侧（IOM）和黄斑颞外侧（TOM）的平均厚度显著增加（p < 0.05），术后3个月恢复到术前水平（p > 0.05）。在每个时间点，第1组和第2组在黄斑厚度变化方面无显著差异（p > 0.05）。在仅接受GATT手术的1例患者中观察到术后具有临床意义的黄斑囊样水肿（p = 0.351）。
GATT可能是一种安全的手术，对黄斑厚度和结构的不良影响最小且短暂。GATT与CE联合进行不会额外增加黄斑增厚的风险。
