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Graefe's Archive for Clinical and Experimental Ophthalmology

Published in:

07-10-2023 | Trabeculectomy | Glaucoma

Comparison of clinical outcomes between gonioscopy-assisted transluminal trabeculotomy and trabeculectomy in advanced-stage pseudoexfoliation glaucoma

Authors: Murat Gunay, Ibrahim Mert Kurt, Adem Turk, Hidayet Erdol, Nurettin Akyol, Halil Ibrahim Imamoglu, Dilek Uzlu

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 2/2024

Abstract

Purpose

To compare clinical outcomes between gonioscopy-assisted transluminal trabeculotomy (GATT) and trabeculectomy (TRAB) in patients with advanced-stage pseudoexfoliation glaucoma (PEXG).

Methods

This comparative study comprised 62 patients who underwent GATT (N = 31) or TRAB (N = 31) for advanced-stage PEXG. Primary outcome was cumulative probability of surgical success at the end of 12-month follow-up. Success was determined as intraocular pressure (IOP) reduction ≥ 30% from baseline, IOP between 6 and 18 mmHg and IOP upper limits for IOP < 15 mmHg and < 12 mmHg, separately. Secondary outcomes were IOP reduction, antiglaucoma medication (AGM) use, and complications in the study.

Results

Age, sex, cup/disc ratio, mean deviation, pattern standard deviation, and retinal nerve fiber layer thickness did not significantly differ between the groups (p > 0.05 for all). The probability of cumulative surgical success at the end of 12 months was similar between the two groups for IOP < 15 mmHg and < 18 mmHg but significantly higher after TRAB (92.0%) than GATT (82.5%) for IOP < 12 mmHg (log-rank test p = 0.035). Percentage of IOP reduction from baseline was similar between the groups (53.1 ± 18.6% in GATT group and 53.0 ± 16.6% in TRAB group, p = 0.98) at the end of 12 months. No significant difference in the mean number of AGM was present at the 12-month visit (1.3 ± 1.4 in GATT and 1.1 ± 1.4 in TRAB, p = 0.65).

Conclusion

At the end of 12 months, IOP reduction rate was similar between GATT and TRAB. Cumulative surgical success was higher after TRAB than GATT for IOP < 12 mmHg.

Gillmann K, Meduri E, Niegowski LJ, Mermoud A (2021) Surgical management of pseudoexfoliative glaucoma: a review of current clinical considerations and surgical outcomes. J Glaucoma 30:e32–e39. https://doi.org/10.1097/IJG.0000000000001724CrossRefPubMed

Mastronikolis S, Pagkalou M, Plotas P, Kagkelaris K, Georgakopoulos CD (2022) Emerging roles of oxidative stress in the pathogenesis of pseudoexfoliation syndrome (Review). Exp Ther Med 24:602. https://doi.org/10.3892/etm.2022.11539CrossRefPubMedPubMedCentral

Plateroti P, Plateroti AM, Abdolrahimzadeh S, Scuderi G (2015) Pseudoexfoliation syndrome and pseudoexfoliation glaucoma: a review of the literature with updates on surgical management. J Ophthalmol 2015:370371. https://doi.org/10.1155/2015/370371CrossRefPubMedPubMedCentral

Coulon SJ, Vanner EA, Gedde SJ, Primary Tube Versus Trabeculectomy Study Group (2023) Outcomes of glaucoma reoperations in the Primary Tube Versus Trabeculectomy Study. Ophthalmol Glaucoma S2589-4196(23):00052–2. https://doi.org/10.1016/j.ogla.2023.02.003CrossRef

Birnbaum FA, Neeson C, Solá-Del Valle D (2021) Microinvasive glaucoma surgery: an evidence-based review. Semin Ophthalmol 36:772–786. https://doi.org/10.1080/08820538.2021.1903513CrossRefPubMed

Grover DS, Godfrey DG, Smith O, Feuer WJ, Montes de Oca I, Fellman RL (2014) Gonioscopy-assisted transluminal trabeculotomy, ab interno trabeculotomy: technique report and preliminary results. Ophthalmology 121:855–861. https://doi.org/10.1016/j.ophtha.2013.11.001CrossRefPubMed

Aktaş Z, Özmen MC, Zeydanlı EÖ, Oral M, Eskalen O (2023) Efficacy and safety of gonioscopy-assisted transluminal trabeculotomy for primary congenital glaucoma. J Glaucoma. https://doi.org/10.1097/IJG.0000000000002192CrossRefPubMed

Aktas Z, Ucgul AY, Bektas C, Sahin Karamert S (2019) Surgical outcomes of prolene gonioscopy-assisted transluminal trabeculotomy in patients with moderate to advanced open-angle glaucoma. J Glaucoma 28:884–888. https://doi.org/10.1097/IJG.0000000000001331CrossRefPubMed

Boese EA, Shah M (2019) Gonioscopy-assisted transluminal trabeculotomy (GATT) is an effective procedure for steroid-induced glaucoma. J Glaucoma 28:803–807. https://doi.org/10.1097/IJG.0000000000001317CrossRefPubMed

10.

Sharkawi E, Lindegger DJ, Artes PH et al (2021) Outcomes of gonioscopy-assisted transluminal trabeculotomy in pseudoexfoliative glaucoma: 24-month follow-up. Br J Ophthalmol 105:977–982. https://doi.org/10.1136/bjophthalmol-2020-315954CrossRefPubMed

11.

Fontana L, De Maria M, Caristia A et al (2021) Comparison of gonioscopy-assisted transluminal trabeculotomy versus trabeculectomy with mitomycin C in patients with open-angle glaucoma. J Glaucoma 30:101–108. https://doi.org/10.1097/IJG.0000000000001696CrossRefPubMed

12.

Olgun A, Celik HU, Yenihayat F, Bozkurt E, Sahbaz İ (2022) Efficacy comparison of combined trabeculectomy with MMC and gonioscopy-assisted transluminal trabeculotomy. Int Ophthalmol 42:1711–1718. https://doi.org/10.1007/s10792-021-02166-5CrossRefPubMed

13.

Hodapp E, Parrish RK, Anderson DR (1993) Clinical decisions in glaucoma. Louis, MO: Mosby Incorporated

14.

World Glaucoma Association. Guidelines on design and reporting of glaucoma surgical trials (2009) In: Shaarawy TM, Sherwood MB, Grehn F, eds. Amsterdam: Kugler Publications

15.

Ma AK, Lee JH, Warren JL, Teng CC (2020) GlaucoMap - distribution of glaucoma surgical procedures in the United States. Clin Ophthalmol 14:2551–2560. https://doi.org/10.2147/OPTH.S257361CrossRefPubMedPubMedCentral

16.

Velamala IP, Bharathi M (2023) Gonioscopy assisted transluminal trabeculotomy:a boon to developing nations-a systematic review. Semin Ophthalmol 38:178–182. https://doi.org/10.1080/08820538.2022.2094715CrossRefPubMed

17.

Ernest PJ, Schouten JS, Beckers HJ, Hendrikse F, Prins MH, Webers CA (2013) An evidence-based review of prognostic factors for glaucomatous visual field progression. Ophthalmology 120:512–519. https://doi.org/10.1016/j.ophtha.2012.09.005CrossRefPubMed

18.

Tarkkanen A, Kivelä T (2018) Weekly fluctuation of intraocular pressure in exfoliation glaucoma: long-term follow-up with self-tonometry. Acta Ophthalmol 96:e1035–e1037. https://doi.org/10.1111/aos.13778CrossRefPubMed

19.

Latif K, Nishida T, Moghimi S, Weinreb RN (2023) Quality of life in glaucoma. Graefes Arch Clin Exp Ophthalmol. https://doi.org/10.1007/s00417-023-06050-zCrossRefPubMed

20.

Villasana GA, Bradley C, Ramulu P, Unberath M, Yohannan J (2022) The effect of achieving target intraocular pressure on visual field worsening. Ophthalmology 129:35–44. https://doi.org/10.1016/j.ophtha.2021.08.025CrossRefPubMed

21.

Rao A, Cruz RD (2022) Trabeculectomy: does it have a future? Cureus 14(8):e27834. https://doi.org/10.7759/cureus.27834CrossRefPubMedPubMedCentral

22.

Aktas Z, Ozdemir Zeydanli E, Uysal BS, Yigiter A (2022) Outcomes of prolene gonioscopy assisted transluminal trabeculotomy in primary open angle glaucoma and pseudoexfoliation glaucoma: a comparative study. J Glaucoma 31:751–756. https://doi.org/10.1097/IJG.0000000000002063CrossRefPubMed

23.

Vazquez LE, Lee RK (2014) Genomic and proteomic pathophysiology of pseudoexfoliation glaucoma. Int Ophthalmol Clin 54:1–13. https://doi.org/10.1097/IIO.0000000000000047CrossRefPubMedPubMedCentral

24.

Bao W, Kawase K, Huang H, Sawada A, Yamamoto T (2019) The long-term outcome of trabeculotomy: comparison with filtering surgery in Japan. BMC Ophthalmol 19(1):99. https://doi.org/10.1186/s12886-019-1107-0CrossRefPubMedPubMedCentral

25.

Aktas Z, Hepsen IF, Dilekmen N, Onol M (2016) Are the outcomes of circumferential trabeculotomy for adult open angle glaucoma comparable to those of trabeculectomy? Clin Exp Ophthalmol 44:858–859. https://doi.org/10.1111/ceo.12778CrossRefPubMed

26.

Matlach J, Dhillon C, Hain J, Schlunck G, Grehn F, Klink T (2015) Trabeculectomy versus canaloplasty (TVC study) in the treatment of patients with open-angle glaucoma: a prospective randomized clinical trial. Acta Ophthalmol 93:753–761. https://doi.org/10.1111/aos.12722CrossRefPubMedPubMedCentral

27.

Grover DS, Smith O, Fellman RL et al (2018) Gonioscopy-assisted transluminal trabeculotomy: an ab interno circumferential trabeculotomy: 24 months follow-up. J Glaucoma 27:393–401. https://doi.org/10.1097/IJG.0000000000000956CrossRefPubMed

28.

Pillunat LE, Erb C, Jünemann AG, Kimmich F (2017) Micro-invasive glaucoma surgery (MIGS): a review of surgical procedures using stents. Clin Ophthalmol 11:1583–1600. https://doi.org/10.2147/OPTH.S135316CrossRefPubMedPubMedCentral

29.

Kazemian P, Lavieri MS, Van Oyen MP, Andrews C, Stein JD (2018) Personalized prediction of glaucoma progression under different target intraocular pressure levels using filtered forecasting methods. Ophthalmology 125(4):569–577. https://doi.org/10.1016/j.ophtha.2017.10.033CrossRefPubMed

30.

Cakir I, Altan C, Yalcinkaya G, Ozveren M, Kabakci AK, Taskapili M (2022) Evaluation of post phacoemulsification inflammation in eyes with and without pseudoexfoliation syndrome according to phaco parameters via laser flare photometry. Photodiagnosis Photodyn Ther 38:102805. https://doi.org/10.1016/j.pdpdt.2022.102805CrossRefPubMed

31.

Gedde SJ, Feuer WJ, Lim KS et al (2022) Postoperative complications in the primary tube versus trabeculectomy study during 5 years of follow-up. Ophthalmology 129:1357–1367. https://doi.org/10.1016/j.ophtha.2022.07.004CrossRefPubMed

32.

Rao A, Cruz RD (2023) Cataract versus combined surgery in pseudoexfoliation glaucoma. Indian J Ophthalmol 71:797–802. https://doi.org/10.4103/ijo.IJO_1669_22CrossRefPubMedPubMedCentral

33.

Hamze H, Mohite AA, Pandey P, Sung VCT, Masood I (2021) Comparison of 1-year surgical outcomes of combined cataract surgery and gonioscopy-assisted transluminal trabeculotomy (GATT) versus cataract surgery and iStent Inject. Graefes Arch Clin Exp Ophthalmol 259:3035–3044. https://doi.org/10.1007/s00417-021-05133-zCrossRefPubMed

Title: Comparison of clinical outcomes between gonioscopy-assisted transluminal trabeculotomy and trabeculectomy in advanced-stage pseudoexfoliation glaucoma
Authors: Murat Gunay
Ibrahim Mert Kurt
Adem Turk
Hidayet Erdol
Nurettin Akyol
Halil Ibrahim Imamoglu
Dilek Uzlu
Publication date: 07-10-2023
Publisher: Springer Berlin Heidelberg
Keywords: Trabeculectomy
Glaucoma
Trabeculotomy
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 2/2024
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-023-06246-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparison of clinical outcomes between gonioscopy-assisted transluminal trabeculotomy and trabeculectomy in advanced-stage pseudoexfoliation glaucoma

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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