Yuksel Elgin Cansu, Hepokur Mustafa
Istanbul University-Cerrahpasa Department of Ophthalmology, Kocamustafapasa Cad. No 53, Fatih Istanbul, 34098, Türkiye.
BMC Ophthalmol. 2025 Apr 7;25(1):180. doi: 10.1186/s12886-025-04035-6.
This study aimed to investigate the outcomes of gonioscopy-assisted transluminal trabeculectomy (GATT) surgery in patients with Fuchs' uveitis syndrome (FUS) related glaucoma.
The clinical and surgical records of 4 FUS patients who underwent GATT surgery between 2021 and 2023 were retrospectively reviewed. The preoperative process, clinical course under medical treatment, postoperative clinical course, intraocular pressures (IOP), glaucoma medication requirements, need for additional surgeries, visual outcomes, and surgical success results were evaluated for each patient GATT surgery was performed as the first intervention for glaucoma control in FUS patients under 50 years of age with IOP above 20 mm Hg despite multiple different medications. The average follow-up period after GATT surgery was 12 months. Despite reaching the maximum level of antiglaucomatous treatment in any of the patients, the target IOP was not achieved. On average, 6 months later, mitomycin-C trabeculectomy (MMC-trab) was performed as a conventional surgical option in three of the patients, and diode laser cyclophotocoagulation was applied to one patient with poor visual prognosis.
In FUS, which causes low-grade inflammation, has a low likelihood of synechial formation, and relatively affects a younger age group, GATT surgery, a minimally invasive glaucoma surgery (MIGS) method, was considered a good alternative as an initial surgical option. However, it was observed that the surgical success was limited.
本研究旨在调查房角镜辅助经腔小梁切除术（GATT）治疗Fuchs葡萄膜炎综合征（FUS）相关青光眼患者的疗效。
回顾性分析了2021年至2023年间接受GATT手术的4例FUS患者的临床和手术记录。评估了每位患者的术前过程、药物治疗下的临床病程、术后临床病程、眼压（IOP）、青光眼药物需求、额外手术需求、视力结果和手术成功率。GATT手术是对50岁以下、尽管使用多种不同药物但眼压仍高于20 mmHg的FUS青光眼患者进行青光眼控制的首次干预措施。GATT手术后的平均随访期为12个月。尽管所有患者均达到了最大抗青光眼治疗水平，但目标眼压仍未实现。平均6个月后，3例患者接受了丝裂霉素C小梁切除术（MMC-trab）作为传统手术选择，1例视力预后较差的患者接受了二极管激光睫状体光凝术。
在引起低度炎症、虹膜粘连形成可能性低且相对影响年轻人群的FUS中，GATT手术作为一种微创青光眼手术（MIGS）方法，被认为是一种很好的初始手术选择替代方案。然而，观察到手术成功率有限。
