Gunay Murat, Uzlu Dilek, Akyol Nurettin
Faculty of Medicine, Department of Ophthalmology, Karadeniz Technical University, Trabzon, Turkey.
Department of Ophthalmology, Kuzey Eye Hospital, Trabzon, Turkey.
Ocul Immunol Inflamm. 2023 Dec;31(10):2060-2064. doi: 10.1080/09273948.2023.2221965. Epub 2023 Jun 21.
Gonioscopy-assisted transluminal trabeculotomy (GATT) has been used as a safe and effective procedure in the treatment of open angle glaucoma. In the present report, we demonstrated successful IOP control in two uveitic glaucoma cases secondary to juvenile idiopathic arthritis (JIA) following 360° GATT. Case 1 was a 7-year-old pseudophakic male with a preoperative IOP of 38 mmHg; his IOP stabilized at 17 mmHg with two topical antiglaucoma medications over 18 months. Case 2 was a 8-year-old aphakic male with a preoperative IOP of 42 mmHg; his IOP decreased to 12 mmHg over 15 months. We observed postoperative IOP spike in case 1 which was successfully controlled conservatively. Peripheral anterior synechia formation also occured in both cases during follow-up. One should be vigilant for possible complications after GATT in such cases. As glaucoma surgery success can have a tendency to decline with time in pediatric cases with uveitis-associated glaucoma, we believe that further evidence is still required to shed more light about the benefits of GATT technique in complex cases of pediatric secondary glaucoma subtypes like JIAU-induced glaucoma.
房角镜辅助经腔小梁切开术（GATT）已被用作治疗开角型青光眼的一种安全有效的手术方法。在本报告中，我们展示了在360°GATT术后，两例继发于幼年特发性关节炎（JIA）的葡萄膜炎性青光眼病例的眼压得到了成功控制。病例1是一名7岁的人工晶状体植入男性，术前眼压为38 mmHg；在18个月内使用两种局部抗青光眼药物后，其眼压稳定在17 mmHg。病例2是一名8岁的无晶状体男性，术前眼压为42 mmHg；在15个月内其眼压降至12 mmHg。我们观察到病例1术后出现眼压峰值，经保守治疗成功控制。随访期间，两例均出现周边前粘连形成。在这类病例中，GATT术后应警惕可能出现的并发症。由于葡萄膜炎相关性青光眼患儿的青光眼手术成功率可能会随着时间推移而下降，我们认为仍需要进一步的证据来更清楚地了解GATT技术在诸如幼年特发性关节炎葡萄膜炎所致青光眼等复杂儿童继发性青光眼亚型病例中的益处。
