Journal francais d'ophtalmologie · 2026
Clinical effect of trabecular meshwork peeling in gonioscopy-assisted transluminal trabeculotomy (GATT).
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Durmuş Ece B Ş, Yozgat Z, Işık M U, Furuncuoğlu U, İlgüy S, Yüksel E
Аннотация
PURPOSE: To determine the effect of trabecular meshwork (TM) peeling on gonioscopy-assisted transluminal trabeculotomy (GATT) surgical outcomes in patients with open-angle glaucoma.
METHODS: In this retrospective cross-sectional study, patients who underwent GATT surgery with 5/0 prolene for moderate-to-advanced glaucoma were included. In group 1, the TM was only torn using a prolene suture, and in group 2, the TM was peeled after tearing. A decrease in intraocular pressure (IOP) below 18mmHg after surgery without the need for glaucoma medications or a 30% decrease in IOP from preoperative values were accepted as complete success. Achieving the same outcome with a maximum of two topical medications was defined as a qualified success. The requirement for additional surgery was defined as a failure. Patient demographics, pre- and postoperative IOP, number of glaucoma medications, complete and qualified surgical success, mean retinal nerve fiber layer thickness, and surgical complications were evaluated.
RESULTS: Each group contained twenty eyes. Complete trabeculotomy (360°) was performed in 60% of group 1 and 80% of group 2 patients; partial trabeculotomy (200°-270°) was performed in 40% of group 1 and 20% of group 2 patients. Both groups had similar mean IOP levels and number of medications (P>0.05). Surgical success rates were similar between patient groups (P>0.05). Hyphema, which resolved spontaneously, occurred in 75% of group 1 and 70% of group 2.
CONCLUSION: In conclusion, adding TM peeling to GATT surgery did not improve early postoperative outcomes. Longitudinal investigations with a larger patient group are needed.
METHODS: In this retrospective cross-sectional study, patients who underwent GATT surgery with 5/0 prolene for moderate-to-advanced glaucoma were included. In group 1, the TM was only torn using a prolene suture, and in group 2, the TM was peeled after tearing. A decrease in intraocular pressure (IOP) below 18mmHg after surgery without the need for glaucoma medications or a 30% decrease in IOP from preoperative values were accepted as complete success. Achieving the same outcome with a maximum of two topical medications was defined as a qualified success. The requirement for additional surgery was defined as a failure. Patient demographics, pre- and postoperative IOP, number of glaucoma medications, complete and qualified surgical success, mean retinal nerve fiber layer thickness, and surgical complications were evaluated.
RESULTS: Each group contained twenty eyes. Complete trabeculotomy (360°) was performed in 60% of group 1 and 80% of group 2 patients; partial trabeculotomy (200°-270°) was performed in 40% of group 1 and 20% of group 2 patients. Both groups had similar mean IOP levels and number of medications (P>0.05). Surgical success rates were similar between patient groups (P>0.05). Hyphema, which resolved spontaneously, occurred in 75% of group 1 and 70% of group 2.
CONCLUSION: In conclusion, adding TM peeling to GATT surgery did not improve early postoperative outcomes. Longitudinal investigations with a larger patient group are needed.