Üçgül Ahmet Yücel, Kılıç Üçgül Rukiye, Aktaş Zeynep
Kırşehir Ahi Evran University, Training and Research Hospital, Department of Ophthalmology, Kırşehir, Türkiye.
Atılım University Faculty of Medicine, Department of Ophthalmology, Ankara, Türkiye.
Turk J Ophthalmol. 2025 Jun 25;55(3):141-147. doi: 10.4274/tjo.galenos.2025.44773.
OBJECTIVES: To compare the efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) and bent ab interno needle goniectomy (BANG) in patients with open-angle glaucoma (OAG). MATERIALS AND METHODS: This retrospective comparative study included 65 eyes diagnosed with OAG that underwent GATT (34 eyes) or BANG (31 eyes). Intraocular pressure (IOP) was measured using Goldmann applanation tonometry at baseline and during follow-up visits. Success was categorized as qualified (IOP ≤21 mmHg with ≥20% reduction) and complete (same criteria without medication). Complications and the need for further surgery were recorded. RESULTS: Preoperative mean IOP was 32.9±6.1 mmHg for GATT and 31.8±5.4 mmHg for BANG. At the final visit, mean IOP was reduced to 15.8±4.5 mmHg in the GATT group (51.9% reduction) and 17.9±5.7 mmHg in the BANG group (43.7% reduction). The complete success rate was 88.2% for GATT and 61.3% for BANG. Early failures were more frequent in BANG, while GATT showed fewer but later failures. Both procedures had minimal complications, with transient hyphema being the most common. CONCLUSION: In this study, GATT provided greater and more sustained IOP reduction and higher long-term success rates compared to BANG, making it a more reliable option for managing OAG.
目的:比较前房角镜辅助小梁切开术(GATT)和内路弯针小梁切除术(BANG)治疗开角型青光眼(OAG)患者的疗效和安全性。 材料与方法:这项回顾性比较研究纳入了65只诊断为OAG并接受GATT(34只眼)或BANG(31只眼)治疗的眼睛。在基线和随访期间使用Goldmann压平眼压计测量眼压。成功分为合格(眼压≤21 mmHg且降低≥20%)和完全成功(符合相同标准且无需药物治疗)。记录并发症及进一步手术的需求。 结果:GATT术前平均眼压为32.9±6.1 mmHg,BANG术前平均眼压为31.8±5.4 mmHg。在最后一次随访时,GATT组平均眼压降至15.8±4.5 mmHg(降低51.9%),BANG组平均眼压降至17.9±5.7 mmHg(降低43.7%)。GATT的完全成功率为88.2%,BANG为61.3%。BANG早期失败更常见,而GATT失败较少但较晚出现。两种手术并发症均极少,短暂性前房积血最为常见。 结论:在本研究中,与BANG相比,GATT能更显著且持续地降低眼压,长期成功率更高,使其成为治疗OAG更可靠的选择。
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