A new device for performing gonioscopy assisted transluminal trabeculotomy surgery
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First Author: L.Fontana ITALY
To describe a new device for gonioscopy assisted transluminal trabeculotomy (GATT) surgery utilizing a specially developed prolene 6.0 suture (Onalene, Sharpoint, Surgical Specialties, Westwood, MA, USA).
Retrospective case series of consecutive cases operated at Ophthalmic Unit, AUSL-IRCCS Reggio Emilia, Italy
Ten patients with uncontrolled glaucoma who underwent GATT using the prolene 6.0 suture were retrospectively analyzed. Primary outcome measure was the success rate of intraocular pressure (IOP) reduction. Success was defined as IOP < 21 mmHg after 12 months from surgery with (complete) or without (qualified) use of medications. Secondary outcomes were: number of glaucoma medications after surgery, response duration, GATT feasibility, learning curve, postoperative complications, and reintervention.
A complete 360° trabeculotomy was accomplished in 9 patients. Mean (± SD) preoperative and postoperative IOP was 27.59 (± 4.70) mmHg and 15.26 (± 3.47) mmHg respectively. At 12 months after surgery, patients had a mean (±SD) IOP decrease of -11.64 ± 5.33 mmHg from baseline (p<0.001). The overall success rate was 77.04%. The average (±SD) number of medications was 2.13±0.76. Most frequent complication was hyphema. None of the patients required retreatment.
This specially developed suture enabled a complete trabeculotomy ab interno in the majority of patients. A steady, significant lowering of the IOP was achieved and maintained up to 12 months after surgery.