Aktas Zeynep, El Sayed Yasmine, Ucgul Ahmet Yucel, Gawdat Ghada, Elhilali Hala, Aboalazayem Fayrouz
Atılım University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey.
Cairo University Faculty of Medicine, Department of Ophthalmology, Kasr Al Aini, Cairo, Egypt.
Ophthalmol Glaucoma. 2025 Jul-Aug;8(4):407-413. doi: 10.1016/j.ogla.2025.03.009. Epub 2025 Mar 27.
To evaluate the effectiveness and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) in managing early-onset glaucoma secondary to Sturge-Weber syndrome (SWS).
A retrospective interventional case series.
Medical records of 16 patients (22 eyes) diagnosed with early-onset glaucoma secondary to SWS who underwent GATT surgery were reviewed.
All patients underwent GATT surgery using a 5-0 or 6-0 prolene suture under general anesthesia.
The primary outcomes were intraocular pressure (IOP) reduction, complete surgical success (IOP ≤ 18 mmHg without medications), qualified surgical success (IOP ≤ 18 mmHg with medications), and postoperative complications.
The mean IOP decreased significantly from 25.4 ± 4.8 mmHg at baseline to 15.7 ± 4.2 mmHg at the final follow-up (P < 0.001), representing a 38.19% reduction. The mean age at the time of GATT surgery was 33.6 ± 33.9 months. The mean follow-up duration was 16.3 ± 6.4 months. Complete surgical success was achieved in 45.4% of eyes (10 out of 22), while qualified success was reached in 81.8% of eyes (18 out of 22). Despite the overall success, 18.1% of eyes (4 eyes) required additional surgical interventions during the follow-up period. These included Ahmed glaucoma valve implantation in 1 eye, trabeculectomy in 2 eyes, and transscleral diode laser cyclophotocoagulation in 1 eye. Transient hyphema was the only reported complication, resolving spontaneously within 1 week without further intervention.
Gonioscopy-assisted transluminal trabeculotomy appears to be a promising surgical option for managing early-onset glaucoma in patients with SWS, offering significant IOP reduction and a favorable safety profile within the limitations of our study. However, further studies with longer follow-up periods and comparative groups are necessary to confirm these findings.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
评估前房角镜辅助经腔小梁切开术（GATT）治疗斯特奇-韦伯综合征（SWS）继发的早发性青光眼的有效性和安全性。
一项回顾性干预性病例系列研究。
对16例（22只眼）诊断为SWS继发早发性青光眼并接受GATT手术的患者的病历进行回顾。
所有患者在全身麻醉下使用5-0或6-0聚丙烯缝线进行GATT手术。
主要观察指标为眼压降低、手术完全成功（眼压≤18 mmHg且无需药物治疗）、手术合格成功（眼压≤18 mmHg且需药物治疗）及术后并发症。
平均眼压从基线时的25.4±4.8 mmHg显著降至末次随访时的15.7±4.2 mmHg（P<0.001），降幅为38.19%。GATT手术时的平均年龄为33.6±33.9个月。平均随访时间为16.3±6.4个月。45.4%的患眼（22只眼中的10只）实现了手术完全成功，81.8%的患眼（22只眼中的18只）达到了手术合格成功。尽管总体手术成功，但18.1%的患眼（4只眼）在随访期间需要额外的手术干预。其中包括1只眼植入艾哈迈德青光眼引流阀、2只眼行小梁切除术、1只眼行经巩膜二极管激光睫状体光凝术。短暂性前房积血是唯一报告的并发症，无需进一步干预即可在1周内自行消退。
在前房角镜辅助经腔小梁切开术似乎是治疗SWS患者早发性青光眼的一种有前景的手术选择，在我们研究的局限性范围内能显著降低眼压且安全性良好。然而，需要进一步开展随访时间更长且设有对照组的研究来证实这些发现。
作者对本文讨论的任何材料均无所有权或商业利益。
