Indian journal of ophthalmology · 2026
Early outcomes of combined suture gonioscopy-assisted transluminal trabeculotomy and phacoemulsification in Indian eyes: A retrospective study.
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Bhomaj Pooja, Patel Rutul, Pujari Tejaswi, Salunkhe Rameshwari
Аннотация
PURPOSE: To analyze early outcomes and safety profiles of combined phacoemulsification and suture gonioscopy-assisted transluminal trabeculotomy (phaco-GATT) in Indian eyes with primary and secondary (pseudoexfoliative) glaucoma coexisting with cataract.
METHODS: In this retrospective interventional analysis, 42 eyes with primary and secondary (pseudoexfoliative) glaucoma, all with coexisting cataract having follow-up of 6 months to 1 year, were included. Phacoemulsification with suture GATT was performed. Outcome measures included surgical success rate (complete and qualified), intraocular pressure (IOP) reduction post surgery, change in antiglaucoma medications (AGMs) post surgery, change in best corrected visual acuity, and surgical complications. IOP reduction <18 mmHg or ≥30% from baseline without AGM was defined as complete success. IOP reduction <18 mmHg or ≥30% from baseline with AGM was considered as qualified success.
RESULTS: Mean baseline IOP reduced significantly from 23.05+- 7.42 mmHg to 13.4+- 3.20 mmHg at 1 year ( P < 0.001, n = 30), with a 44% IOP reduction. Mean AGM use decreased from 1.93+- 0.52 to 0.13+-0.43 at 1 year ( P < 0.001, n = 30). The complete and qualified success rates at 1 year were 90% and 93%, respectively. BCVA improved from 0.533+- 0.36 logMAR to 0.013+-0.050 logMAR ( P < 0.001). Common complications were IOP spikes (19%) and transient hyphema (16%), all resolving without major intervention.
CONCLUSION: Combined phaco-GATT is a cost-effective and safe surgery with favorable early outcomes, providing significant IOP reduction, reduced medication burden, and minimal complications in patients with primary and secondary (pseudoexfoliative) glaucoma. As a conjunctiva sparing technique, it preserves future surgical options and may delay or avoid need for trabeculectomy.
METHODS: In this retrospective interventional analysis, 42 eyes with primary and secondary (pseudoexfoliative) glaucoma, all with coexisting cataract having follow-up of 6 months to 1 year, were included. Phacoemulsification with suture GATT was performed. Outcome measures included surgical success rate (complete and qualified), intraocular pressure (IOP) reduction post surgery, change in antiglaucoma medications (AGMs) post surgery, change in best corrected visual acuity, and surgical complications. IOP reduction <18 mmHg or ≥30% from baseline without AGM was defined as complete success. IOP reduction <18 mmHg or ≥30% from baseline with AGM was considered as qualified success.
RESULTS: Mean baseline IOP reduced significantly from 23.05+- 7.42 mmHg to 13.4+- 3.20 mmHg at 1 year ( P < 0.001, n = 30), with a 44% IOP reduction. Mean AGM use decreased from 1.93+- 0.52 to 0.13+-0.43 at 1 year ( P < 0.001, n = 30). The complete and qualified success rates at 1 year were 90% and 93%, respectively. BCVA improved from 0.533+- 0.36 logMAR to 0.013+-0.050 logMAR ( P < 0.001). Common complications were IOP spikes (19%) and transient hyphema (16%), all resolving without major intervention.
CONCLUSION: Combined phaco-GATT is a cost-effective and safe surgery with favorable early outcomes, providing significant IOP reduction, reduced medication burden, and minimal complications in patients with primary and secondary (pseudoexfoliative) glaucoma. As a conjunctiva sparing technique, it preserves future surgical options and may delay or avoid need for trabeculectomy.