Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Rd, 200031, Shanghai, China.
BMC Ophthalmol. 2024 Feb 26;24(1):88. doi: 10.1186/s12886-024-03351-7.
This retrospective study aimed to evaluate the efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) in Chinese patients with primary congenital glaucoma (PCG) and identify factors influencing surgical success.
Fourteen patients (24 eyes) diagnosed with PCG who underwent gonioscopy-assisted transluminal trabeculotomy were recruited, and data on intraocular pressure (IOP), antiglaucoma medication, surgery-related complications, and additional treatments were collected during preoperative and postoperative visits. Surgical success was defined as IOP ≤ 21 mmHg and a reduction of > 30% from baseline, with (partial success) or without (complete success) antiglaucoma medication.
Mean preoperative IOP was 30.41 ± 6.09 mmHg. At the final visit, mean IOP reduction was 16.1 ± 9.1 mmHg (52%), and 19 of 24 eyes were topical medication-free. IOP was significantly decreased at each postoperative visit compared with baseline (P < 0.05 for all time points). Cumulative proportions of complete and partial success were 79.2% and 95.8%, respectively, at three years postsurgery. Patients without prior antiglaucoma procedures, without postoperative IOP spikes, and those undergoing complete trabeculotomy exhibited improved surgical prognosis. No permanent vision-threatening complications occurred in the 24 eyes by the end of the respective follow-ups.
Gonioscopy-assisted transluminal trabeculotomy emerged as a safe and effective procedure for PCG treatment, characterized by outstanding IOP reduction efficacy and high surgical success rates.
本回顾性研究旨在评估青光眼引流阀植入术（GATT）治疗中国人原发性先天性青光眼（PCG）的疗效和安全性，并确定影响手术成功率的因素。
本研究纳入了 14 名（24 只眼）被诊断为 PCG 且接受了青光眼引流阀植入术的患者，收集了术前和术后眼压（IOP）、抗青光眼药物、手术相关并发症和其他治疗的数据。手术成功定义为 IOP≤21mmHg，与基线相比降低≥30%，且（部分成功）或无（完全成功）抗青光眼药物。
术前平均 IOP 为 30.41±6.09mmHg。在最后一次随访时，平均 IOP 降低了 16.1±9.1mmHg（52%），24 只眼中有 19 只眼无需使用眼药水。与基线相比，术后每次随访时 IOP 均显著降低（所有时间点 P<0.05）。术后 3 年完全成功和部分成功的累积比例分别为 79.2%和 95.8%。未行术前抗青光眼手术、无术后 IOP 升高和行完全小梁切开术的患者手术预后改善。在各自的随访结束时，24 只眼中没有发生永久性视力威胁性并发症。
青光眼引流阀植入术是治疗 PCG 的一种安全有效的方法，具有出色的降低 IOP 效果和较高的手术成功率。
