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

Eye volume 35, pages 2848–2854 (2021)Cite this article

Subjects

Abstract

Purpose

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

Methods

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.

Results

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%.

Conclusions

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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Funding

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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Author notes

  1. These authors contributed equally: Yiwei Wang, Huaizhou Wang

Authors and Affiliations

  1. Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, 100730, Beijing, China

    Yiwei Wang, Chen Xin, Peng Yin, Meng Li, Kai Cao & Ningli Wang

  2. Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, 100730, Beijing, China

    Huaizhou Wang & Yan Shi

  3. Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA

    Ying Han

  4. Department of Ophthalmology, Beijing Puren Hospital, Beijing, China

    Peng Yin

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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). https://doi.org/10.1038/s41433-020-01320-0

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