Ayub Gabriel, Costa Vital Paulino
Department of Ophthalmology, University of Campinas, Campinas, São Paulo, Brazil.
J Glaucoma. 2025 Sep 10. doi: 10.1097/IJG.0000000000002629.
Gonioscopy-Assisted Transluminal Trabeculotomy achieved a higher success rate than Bent Ab interno Needle Goniotomy in pseudophakic primary open angle glaucoma eyes at 12-months.
To evaluate and compare efficacy and safety of standalone Bent Ab interno Needle Goniotomy (BANG) and Gonioscopy-Assisted Transluminal Trabeculotomy (GATT) in pseudophakic primary open angle glaucoma (POAG) eyes.
Parallel, double-arm, 1:1 ratio, single masked, single surgeon, randomized clinical trial. Uncontrolled mild to moderate pseudophakic POAG eyes, defined by visual field mean deviation, were enrolled. Antiglaucoma medication was washed-out before surgery and at 11-months. Patients were followed by 12 months. Surgical success was defined as 6≤IOP≤18 mm Hg and 20% IOP reduction from baseline with (qualified) or without (complete) the use of medication.
Twenty-two eyes underwent BANG and 23 underwent GATT. At inclusion, mean IOPs were 21.18±2.87 mm Hg versus 19.87±2.34 mm Hg (P=0.1) under 2.41±0.9 versus 2.35±0.88 medications (P=0.71) in the BANG and GATT groups, respectively. Baseline washout IOPs were 25.55±4.9 mm Hg versus 25.43±4.98 mm Hg in the BANG and GATT groups, respectively (P=0.92). At POD330, IOPs in GATT and BANG groups were 15.62±3.29 mm Hg (-21.38%, P=0.04) and 16.95±2.82 mm Hg (-19.97%, P<0.01), respectively (P=0.16). At POD360, after washout, IOPs were 21.57±11.11 mm Hg (-15.17%, P=0.06) and 24.59±7.94 mm Hg (-3.75%, P=0.53) (P=0.31 between the groups). The mean number of medications used at POD330 was 1.1±1.55 in GATT (-53.19%, P<0.01) and 1.82±1.05 in BANG eyes (-24.48%, P=0.06) (P=0.08 between the groups). GATT eyes had higher complete (60.1% vs. 4.5%, P<0.01) and qualified success rates (64.7% vs. 22.7%, P=0.01) than BANG eyes. Transient hyphema was the most common complication following GATT (56.52%) and BANG (40.9%).
GATT eyes achieved higher success rates, lower mean IOPs and required less antiglaucoma medication than BANG eyes after 11-months.
在人工晶状体植入性原发性开角型青光眼眼中，12个月时房角镜辅助经腔小梁切开术的成功率高于内路弯针房角切开术。
评估和比较单纯内路弯针房角切开术（BANG）和房角镜辅助经腔小梁切开术（GATT）在人工晶状体植入性原发性开角型青光眼（POAG）眼中的疗效和安全性。
平行双臂、1:1比例、单盲、单术者的随机临床试验。纳入由视野平均偏差定义的未控制的轻度至中度人工晶状体植入性POAG眼。术前及术后11个月停用抗青光眼药物。对患者进行12个月的随访。手术成功定义为眼压（IOP）≤18 mmHg且眼压较基线降低20%，用药（合格）或未用药（完全）。
22只眼接受了BANG手术，23只眼接受了GATT手术。纳入时，BANG组和GATT组的平均眼压分别为21.18±2.87 mmHg和19.87±2.34 mmHg（P=0.1），用药数量分别为2.41±0.9种和2.35±0.88种（P=0.71）。BANG组和GATT组的基线冲洗后眼压分别为25.55±4.9 mmHg和25.43±4.98 mmHg（P=0.92）。在术后第330天，GATT组和BANG组的眼压分别为15.62±3.29 mmHg（-21.38%，P=0.04）和16.95±2.82 mmHg（-19.97%，P<0.01）（P=0.16）。在术后第360天，冲洗后眼压分别为21.57±11.11 mmHg（-15.17%，P=0.06）和24.59±7.94 mmHg（-3.75%，P=0.53）（两组间P=0.31）。术后第330天GATT组使用的平均药物数量为1.1±1.55种（-53.19%，P<0.01），BANG组为1.82±1.05种（-24.48%，P=0.06）（两组间P=0.08）。GATT组的完全成功率（60.1%对4.5%，P<0.01）和合格成功率（64.7%对22.7%，P=0.01）高于BANG组。短暂性前房积血是GATT（56.52%）和BANG（40.9%）术后最常见的并发症。
11个月后，GATT组的成功率更高，平均眼压更低，所需抗青光眼药物比BANG组更少。
