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Outcomes of gonioscopy-assisted transluminal trabeculotomy in pseudoexfoliative glaucoma: 24-month follow-up
  1. Eamon Sharkawi1,
  2. Daniel Josef Lindegger2,
  3. Paul H Artes3,4,
  4. Lydia Lehmann-Clarke1,
  5. Mohamad El Wardani5,
  6. Marie Misteli5,
  7. Jérôme Pasquier6,
  8. Adriano Guarnieri1
  1. 1 Swiss Eye Centre, Lausanne, Switzerland
  2. 2 Moorfields Eye Hospital, London, London, UK
  3. 3 University of Plymouth, Plymouth, UK
  4. 4 Southwest Eye Institute, Tavistock, UK
  5. 5 Jules Gonin Eye Hospital, Lausanne, Switzerland
  6. 6 Unisanté, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
  1. Correspondence to Eamon Sharkawi, Swiss Eye Centre, Avenue De Rumine 64, Lausanne 1005, Switzerland; e.sharkawi{at}swisseyecentre.ch

Abstract

Aim To report on outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) in eyes with pseudoexfoliative glaucoma (PXG).

Methods Prospective, interventional, non-comparative case series. A total of 103 eyes from 84 patients with PXG were enrolled to undergo a 360-degree ab interno trabeculotomy with gonioscopic assistance using either a 5.0 polypropylene suture or an illuminated microcatheter with up to 24 months of follow-up. Main outcome measures were intraocular pressure (IOP), number of antiglaucoma medications, success rate (IOP reduction ≥20% from baseline or IOP between 6 and 21 mm Hg, without further glaucoma surgery) and complication rate.

Results Mean preoperative IOP was 27.1 mm Hg (95% CI 25.5 to 28.7) using 2.9 (SD 1.1) glaucoma medications which decreased postoperatively to 13.0 mm Hg (95% CI 11.5 to 14.4) and 1.0 (SD 1.1) medications at 24 months (p<0.001). Success rate was 89.2% at 24 months of follow-up, and complication rate was 2.9%.

Conclusion At 24 months of follow-up, our results for GATT in PXG demonstrate that this conjunctival sparing procedure effectively lowers IOP and reduces the medications with a low complication rate, in this relatively aggressive glaucoma subtype.

  • Glaucoma
  • intraocular pressure
  • treatment surgery
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Footnotes

  • Contributors ES: conception, design, drafting the article. DJL: collecting data, drafting the article. PHA: analysis and interpretation of data. LL-C: collecting data, drafting the article. MEW: collecting data, drafting the article. MM: collecting data. JP: analysis and interpretation of data. AG: drafting the article, analysis and interpretation of data. ES, PHA and AG were involved in revising the article critically for important intellectual content. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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