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Outcomes of gonioscopy-assisted transluminal trabeculotomy in juvenile-onset primary open-angle glaucoma



To report the outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) for juvenile-onset primary open-angle glaucoma (JOAG).


A consecutive case series of JOAG patients who underwent GATT was reviewed with follow-up period of up to 18 months. Intraocular pressure (IOP), number of glaucoma medications and success rate were compared between eyes with and without prior glaucoma surgery, and between mild-to-moderate and severe cases defined based on Humphrey Visual Field mean deviation.


In total, 59 eyes of 48 patients were included. Overall, IOP was reduced from 26.5 ± 9.0 mmHg on 3.7 ± 0.9 medications preoperatively to 14.7 ± 3.0 mmHg on 0.7 ± 1.2 medications at 12 months and to 14.1 ± 2.3 mmHg on 0.4 ± 0.8 medications at 18 months postoperatively (P < 0.001). The complete and qualified success rates were 70.8% and 81.2% at 12 months, and 58.6% and 81.2% at 18 months, respectively. Eyes with and without prior glaucoma surgery did not differ significantly in terms of postoperative IOP, glaucoma medication and success rate. In addition, GATT was effective for both mild-to-moderate and severe cases; the latter achieved a surgical success of 79.1%.


GATT is effective for JOAG. In particular, this case series suggests that GATT is promising in treating severe JOAG and those with prior glaucoma surgery.

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Fig. 1: Kaplan–Meier analysis of the cumulative probabilities of surgical success.
Fig. 2: Preoperative versus postoperative IOP and glaucoma medications in eyes without prior glaucoma surgery (Group 1) and those with prior surgery (Group 2).
Fig. 3: The percent reduction of IOP in eyes with mild-to-moderate JOAG (MD ≥ −12 dB) and in eyes with severe JOAG (MD < −12 dB).
Fig. 4: Kaplan–Meier analysis of the cumulative proportion of surgical success in mild-to-moderate (MD ≥ −12 dB) and severe (MD < −12 dB) JOAG.


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This work was supported by National Natural Science Foundation of China (81730027). The funding organization had no role in the design or conduct of this research.

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Correspondence to Ningli Wang.

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Wang, Y., Wang, H., Han, Y. et al. Outcomes of gonioscopy-assisted transluminal trabeculotomy in juvenile-onset primary open-angle glaucoma. Eye 35, 2848–2854 (2021).

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