Indian journal of ophthalmology · 2026
Five-year results of illuminated microcatheter-assisted gonioscopy-assisted transluminal trabeculotomy in the Indian population - A retrospective study.
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Mahajan Ankush, Mahajan Vijay K
Аннотация
PURPOSE: To assess 5-year outcomes regarding the efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) using an illuminated microcatheter in glaucoma patients in India.
METHODS: This retrospective study analyzes clinical records of 110 primary and secondary glaucoma patients treated with either GATT or GATT combined with cataract surgery (GATT+CS) from August 1, 2014 to July 31, 2019 at a single clinical center by one surgeon. The main postoperative outcomes assessed included changes in intraocular pressure (IOP), the use of anti-glaucoma medications (AGMs), the occurrence of complications, and surgical success over a 5-year follow-up period. Absolute success was characterized by an intraocular pressure of ≤18 mmHg, without AGM, and a 30% reduction from baseline.
RESULTS: The average IOP and AGM reduced from 26.46 ± 9.97 mmHg and 2.60 ± 1.27 preoperatively to 13.02 ± 2.01 mmHg and 1.16 ± 1.28 five years after the procedure. The visual acuity improved from 0.89 ± 0.58 to 0.34 ± 0.6 two months after surgery. The absolute and qualified success rates were 50% and 96.55%, respectively, at the 5-year follow-up. Kaplan-Meier analysis showed a 5-year survival rate of 89.46% (95% CI: 82.82-96.12%). A comparison between POAG and PACG showed 5-year survival probabilities of 73.8% and 94.4%, respectively. Although the number of secondary glaucoma eyes was small, they were retained to represent real-world clinical diversity; results are interpreted with caution. Complications observed included transient hyphema (94.5%), vitreous hemorrhage (1.8%), peripheral Descemet's detachment (2.7%), and blood behind the intraocular lens (1.8%). All complications except hyphema took place during the early phase of the study (2014-2015), and none resulted in vision loss at the 3-month follow-up.
CONCLUSIONS: Both GATT and GATT+CS are safe and effective surgical treatments for different types of glaucoma. These findings provide long-term evidence on the efficacy and safety of illuminated microcatheter-assisted GATT in Indian eyes.
METHODS: This retrospective study analyzes clinical records of 110 primary and secondary glaucoma patients treated with either GATT or GATT combined with cataract surgery (GATT+CS) from August 1, 2014 to July 31, 2019 at a single clinical center by one surgeon. The main postoperative outcomes assessed included changes in intraocular pressure (IOP), the use of anti-glaucoma medications (AGMs), the occurrence of complications, and surgical success over a 5-year follow-up period. Absolute success was characterized by an intraocular pressure of ≤18 mmHg, without AGM, and a 30% reduction from baseline.
RESULTS: The average IOP and AGM reduced from 26.46 ± 9.97 mmHg and 2.60 ± 1.27 preoperatively to 13.02 ± 2.01 mmHg and 1.16 ± 1.28 five years after the procedure. The visual acuity improved from 0.89 ± 0.58 to 0.34 ± 0.6 two months after surgery. The absolute and qualified success rates were 50% and 96.55%, respectively, at the 5-year follow-up. Kaplan-Meier analysis showed a 5-year survival rate of 89.46% (95% CI: 82.82-96.12%). A comparison between POAG and PACG showed 5-year survival probabilities of 73.8% and 94.4%, respectively. Although the number of secondary glaucoma eyes was small, they were retained to represent real-world clinical diversity; results are interpreted with caution. Complications observed included transient hyphema (94.5%), vitreous hemorrhage (1.8%), peripheral Descemet's detachment (2.7%), and blood behind the intraocular lens (1.8%). All complications except hyphema took place during the early phase of the study (2014-2015), and none resulted in vision loss at the 3-month follow-up.
CONCLUSIONS: Both GATT and GATT+CS are safe and effective surgical treatments for different types of glaucoma. These findings provide long-term evidence on the efficacy and safety of illuminated microcatheter-assisted GATT in Indian eyes.