Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
Efficacy and safety of gonioscopy-assisted transluminal trabeculotomy in glaucoma secondary to fuchs uveitis syndrome: a multicenter study.
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Oral Merve, Ucgul Ahmet Yucel, Olgun Ali, Gunay Murat, Imamoglu Serhat, Tekcan Hatice, Aktas Zeynep
Аннотация
PURPOSE: To evaluate the long-term surgical outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) in patients with Fuchs uveitis syndrome (FUS)-associated open-angle glaucoma.
METHODS: In this multicenter, retrospective, non-comparative study, 34 consecutive eyes of 31 patients with open-angle glaucoma secondary to FUS who underwent GATT at three tertiary referral centers were included. Patients had inadequate intraocular pressure (IOP) control despite maximal medical therapy and a minimum follow-up of 12 months. Complete success was defined as IOP < 21 mmHg with ≥ 20% reduction from baseline without medication. Qualified success was defined as IOP < 21 mmHg with a ≥ 20% reduction, with or without medication, and no need for additional IOP-lowering surgery. Kaplan-Meier survival analysis was performed to assess cumulative success.
RESULTS: Mean preoperative IOP was 34.9 ± 8.0 mmHg on 3.5 ± 0.7 medications. The mean follow-up duration was 28 ± 7.4 months (range, 12-48). At final visit, mean IOP decreased to 15.7 ± 4.0 mmHg (52.7% reduction; p < 0.001), and medication burden decreased to 1.1 ± 1.2 (70.4% reduction; p < 0.001). The cumulative probability of qualified success was 88.2%, and complete success was 41.2% at 24 months. Hyphema occurred in 14.7% of eyes, and IOP spikes were observed in 14.7%; all were transient. Four eyes (11.8%) required additional glaucoma surgery. No significant loss of visual acuity was observed.
CONCLUSIONS: GATT appears to be a safe and effective surgical option for achieving sustained IOP reduction and decreasing medication burden in FUS-associated glaucoma. Its minimally invasive and conjunctival-sparing nature makes it a reasonable initial surgical strategy in selected patients.
METHODS: In this multicenter, retrospective, non-comparative study, 34 consecutive eyes of 31 patients with open-angle glaucoma secondary to FUS who underwent GATT at three tertiary referral centers were included. Patients had inadequate intraocular pressure (IOP) control despite maximal medical therapy and a minimum follow-up of 12 months. Complete success was defined as IOP < 21 mmHg with ≥ 20% reduction from baseline without medication. Qualified success was defined as IOP < 21 mmHg with a ≥ 20% reduction, with or without medication, and no need for additional IOP-lowering surgery. Kaplan-Meier survival analysis was performed to assess cumulative success.
RESULTS: Mean preoperative IOP was 34.9 ± 8.0 mmHg on 3.5 ± 0.7 medications. The mean follow-up duration was 28 ± 7.4 months (range, 12-48). At final visit, mean IOP decreased to 15.7 ± 4.0 mmHg (52.7% reduction; p < 0.001), and medication burden decreased to 1.1 ± 1.2 (70.4% reduction; p < 0.001). The cumulative probability of qualified success was 88.2%, and complete success was 41.2% at 24 months. Hyphema occurred in 14.7% of eyes, and IOP spikes were observed in 14.7%; all were transient. Four eyes (11.8%) required additional glaucoma surgery. No significant loss of visual acuity was observed.
CONCLUSIONS: GATT appears to be a safe and effective surgical option for achieving sustained IOP reduction and decreasing medication burden in FUS-associated glaucoma. Its minimally invasive and conjunctival-sparing nature makes it a reasonable initial surgical strategy in selected patients.