Department of Ophthalmology, Beyoglu Eye Training and Research Hospital, University of Health Sciences, Turkey.
Indian J Ophthalmol. 2024 Nov 1;72(Suppl 5):S821-S826. doi: 10.4103/IJO.IJO_644_24. Epub 2024 Jul 11.
To compare the intraocular pressure (IOP)-lowering efficiency of gonioscopy-assisted transluminal trabeculotomy (GATT) and trabeculectomy (TRAB) with mitomycin C in patients with primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (PEXG).
In this retrospective comparative study, consecutive patients with POAG or PEXG who underwent GATT or TRAB by a single surgeon and with a follow-up period of at least 1 year were included. Surgical success rates, change in best-corrected visual acuity, IOP, the need for antiglaucoma medication, surgical complications, and the need for additional glaucoma surgery were compared. Surgical success was defined as an IOP reduction of ≥30% or an IOP of ≤18 mmHg. Complete success was defined as without medication. Qualified success was defined as with or without topical medication.
The mean baseline IOP was 27.4 ± 8.3 and 24.6 ± 7.6 mmHg ( P = 0.13) with the mean number of medications being 3.7 ± 1.0 and 3.7 ± 1.1 ( P = 0.98) in TRAB and GATT, respectively. At 12 months, the mean IOP was 15.3 ± 3.5 and 12.5 ± 4.6 mmHg ( P = 0.24) with the mean number of medications being 0.9 ± 1.2 and 0.8 ± 1.4 ( P = 0.76) after GATT and TRAB, respectively. IOP was lowered from baseline by 52.7% ± 17.5% after TRAB and 45.7% ±18.6% after GATT ( P = 0.12). There was no decrease in best-corrected visual acuity in either group. The qualified surgical success rate was 94.4% in the GATT group and 94.9% in the TRAB group ( P = 0.75). Percentage of complete success was 64.1% and 52.8% ( P = 0.22) after TRAB and GATT, respectively.
In patients with POAG and PEXG, GATT was as effective and safe as TRAB in lowering IOP and reducing the number of antiglaucomatous drugs.
比较青光眼引流阀植入术（GATT）和小梁切除术（TRAB）联合丝裂霉素 C 治疗原发性开角型青光眼（POAG）和假性剥脱性青光眼（PEXG）的降眼压效果。
本回顾性对照研究纳入了由同一位外科医生进行 GATT 或 TRAB 治疗且随访时间至少 1 年的 POAG 或 PEXG 连续患者。比较手术成功率、最佳矫正视力变化、眼压、抗青光眼药物需求、手术并发症和需要额外的青光眼手术。手术成功定义为眼压降低≥30%或眼压≤18mmHg。完全成功定义为无需药物治疗。合格成功定义为需要或不需要局部药物治疗。
TRAB 和 GATT 的基线平均眼压分别为 27.4±8.3mmHg 和 24.6±7.6mmHg（P=0.13），平均用药数分别为 3.7±1.0 和 3.7±1.1（P=0.98）。在 12 个月时，TRAB 和 GATT 的平均眼压分别为 15.3±3.5mmHg 和 12.5±4.6mmHg（P=0.24），平均用药数分别为 0.9±1.2 和 0.8±1.4（P=0.76）。TRAB 后眼压降低 52.7%±17.5%，GATT 后降低 45.7%±18.6%（P=0.12）。两组最佳矫正视力均无下降。GATT 组的合格手术成功率为 94.4%，TRAB 组为 94.9%（P=0.75）。TRAB 和 GATT 后完全成功率分别为 64.1%和 52.8%（P=0.22）。
在 POAG 和 PEXG 患者中，GATT 与 TRAB 降低眼压和减少抗青光眼药物方面同样有效且安全。
