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International Ophthalmology

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06-07-2022 | Trabeculotomy | Original Paper

Comparison of combined gonioscopy-assisted transluminal trabeculotomy and cataract extraction with gonioscopy-assisted transluminal trabeculotomy surgery alone on macular thickness

Authors: Mehmet Ozgur Cubuk, Armagan Filik, Ahmet Yucel Ucgul, Hulya Gungel

Published in: International Ophthalmology | Issue 1/2023

Abstract

Purpose

To evaluate the effect of Gonioscopy-assisted transluminal trabeculotomy (GATT) on macular thickness and to compare the combined GATT and cataract extraction (CE) with GATT surgery alone regarding macular thickness.

Methods

A retrospective, comparative study was designed. The patients who underwent GATT or combined GATT and CE with preoperative and regular postoperative spectral domain optic coherence tomography analysis (SD-OCT) were included. The macula was visualized in a 5 × 5 mm² area by SD-OCT using MM5 mode. Two different groups were defined as follows: group 1 enrolled patients who underwent GATT alone, and group 2 enrolled patients who underwent combined GATT and CE. Pre- and postoperative macular thickness measurements by performing intragroup analysis and comparing group 1 with group 2 with regard to change in macular thickness were assessed.

Results

Fifty-four eyes fulfilled the inclusion criteria and were enrolled in this study, (Group 1 = 29 eyes, Group 2 = 25 eyes). The mean thicknesses of central macula (CM), superior inner macula (SIM), and nasal inner macula (NIM) significantly increased 1 month after GATT alone (p < 0.05). This difference became statistically insignificant at 3rd month after the surgery, (p > 0.05). The mean thicknesses of SIM, temporal inner macula (TIM), NIM, superior outer macula (SOM), inferior outer macula (IOM), and temporal outer macula (TOM) showed a significant increase 1 month after combined GATT and CE, (p < 0.05), which return its preoperative levels 3 months after the surgery (p > 0.05). There was no significant difference between group 1 and group 2 with regard to change in macular thickness at each time points, (p > 0.05). Postoperative clinically significant CME was observed in one patient who underwent GATT alone (p = 0.351).

Conclusion

GATT can be a safe procedure with minimal and transient adverse effect on macular thickness and structure. Performing GATT together with CE caused no additional increase in the risk of macular thickening.

Tanihara H, Negi A, Akimoto M et al (1993) Surgical effects of trabeculotomy ab externo on adult eyes with primary open angle glaucoma and pseudoexfoliation syndrome. Arch Ophthalmol 111:1653–1661CrossRef

Ikeda H, Ishigooka H, Muto T et al (2004) Long-term outcome of trabeculotomy for the treatment of developmental glaucoma. Arch Ophthalmol 122(8):1122–1128CrossRef

Grover DS, Godfrey DG, Smith O et al (2014) Gonioscopyassisted transluminal trabeculotomy, ab interno trabeculotomy: technique reportand preliminary results. Ophthalmology 121(4):855–861CrossRef

Cubuk MO, Unsal E (2021) One-year results of gonioscopy-assisted transluminal trabeculotomy: evaluation of prognostic factors. Eur J Ophthalmol 31(2):460–468CrossRef

Grover DS, Godfrey DG, Smith O et al (2017) Outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) in eyes with prior incisional glaucoma surgery. J Glaucoma 26(1):41–45CrossRef

Cubuk MO, Ucgul AY, Unsal E (2020) Gonioscopy-assisted transluminal trabeculotomy as an option after failed trabeculectomy. Int Ophthalmol 40(8):1923–1930CrossRef

Rossetti L, Autelitano A (2000) Cystoid macular edema following cataract surgery. Curr Opin Ophthalmol 11:65–72CrossRef

Flach AJ (1998) The incidence, pathogenesis and treatment of cystoid macular edema following cataract surgery. Trans Am Ophthalmol Soc 96:557–634

Ursell PG, Spalton DJ, Whitcup SM et al (1999) Cystoid macular edema after phacoemulsification: relationship to blood-aqueous barrier damage and visual acuity. J Cataract Refract Surg 25:1492–1497CrossRef

10.

Mentes J, Erakgun T, Afrashi F et al (2003) Incidence of cystoid macular edema after uncomplicated phacoemulsification. Ophthalmologica 217:408–412CrossRef

11.

Lobo C (2012) Pseudophakic cystoid macular edema. Ophthalmologica 227:61–67CrossRef

12.

Karasheva G, Goebel W, Klink T et al (2003) Changes in macular thickness and depth of anterior chamber in patients after filtration surgery. Graefes Arch Clin Exp Ophthalmol 241(3):170–175CrossRef

13.

Kadziauskienė A, Strelkauskaitė E, Mockevičiūtė E et al (2017) Changes in macular thickness after trabeculectomy with or without adjunctive 5-fluorouracil. Acta Med Litu 24(2):93–100

14.

Norregaard JC, Bernth-Petersen P et al (1999) Intraoperative clinical practice and risk of early complications after cataract extraction in the United States, Canada, Denmark, and Spain. Ophthalmology 106(1):42–48CrossRef

15.

Chaudhary C, Bahadhur H, Gupta N (2015) Study of cystoid macular edema by optical coherent tomography following uneventful cataract surgery. Int Ophthalmol. 35(5):685–691CrossRef

16.

Ferrari TM, Cavallo M, Durante G et al (1999) Macular edema induced by phacoemulsification. Doc Ophthalmol 97(3–4):325–327CrossRef

17.

Biro Z, Balla Z, Kovacs B (2008) Change of foveal and perifoveal thickness measured by OCT after phacoemulsification and IOL implantation. Eye 22(1):8–12CrossRef

18.

Georgopoulos GT, Papaconstantinou D, Niskopoulou M et al (2008) Foveal thickness after phacoemulsification as measured by optical coherence tomography. Clin Ophthalmol 2(4):817–820

19.

Sesar A, Cavar I, Sesar AP et al (2013) Macular thickness after glaucoma filtration surgery. Coll Antropol 37(3):841–845

20.

Miyake K, Nishimura K, Harino S et al (2007) The effect of topical diclofenac on choroidal blood flow in early postoperative pseudophakias with regard to cystoid macular edema formation. Invest Ophthalmol Vis Sci 48(12):5647–5652CrossRef

Title: Comparison of combined gonioscopy-assisted transluminal trabeculotomy and cataract extraction with gonioscopy-assisted transluminal trabeculotomy surgery alone on macular thickness
Authors: Mehmet Ozgur Cubuk
Armagan Filik
Ahmet Yucel Ucgul
Hulya Gungel
Publication date: 06-07-2022
Publisher: Springer Netherlands
Keywords: Trabeculotomy
Cataract
Published in: International Ophthalmology / Issue 1/2023
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI: https://doi.org/10.1007/s10792-022-02392-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparison of combined gonioscopy-assisted transluminal trabeculotomy and cataract extraction with gonioscopy-assisted transluminal trabeculotomy surgery alone on macular thickness

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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