The efficacy of gonioscopy-assisted transluminal trabeculectomy combined with phacoemulsification.

PURPOSE To investigate the efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) with or without cataract extraction (CE) in primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (PEX) patients. METHODS A retrospective, non-randomized study included 108 eyes of 108 patients, with a mean age of 65.96 ± 14.84 years, who underwent GATT to treat open-angle glaucoma. We have compared two groups, GATT alone or GATT combined with CE and followed-up minimum for 12 months. Preoperative intraocular pressure (IOP), best-corrected visual acuity (BCVA) compared with final IOP, medication numbers, and BCVA levels. Surgical success was determined as IOP reduction > 20% from baseline, IOP between 5-21 mmHg, if surgery was done for intolerance to medications, preoperative < 21 mmHg with medications, postoperatively < 21 mmHg without medications, and no need for further glaucoma surgery. Also, we defined success with medications and success without medications. High success is defined as IOP < 16 mmHg without medications. RESULTS Success percentiles were found 87.5% for GATT and 83.8% for GATT with CE group (P = 0.811). IOP percentile changes were - 44.25 ± 21.32 in GATT group, - 32.29 ± 23.41 in GATT with CE group, statistically higher change observed in GATT group (P = 0.009). Final IOP levels were found statistically indifferent for comparing GATT and GATT with CE groups and between PEX and POAG groups (respectively, P = 0.412, P = 0.335). CONCLUSION We observed GATT alone has a superior lowering effect on IOP than combined surgery. Final IOP values and success percentiles show us combined surgery is also effective.