GATT: Lens extraction combined with circumferential ab interno trabeculotomy for the treatment of pigmentary glaucoma
Summary
Objective: To evaluate the 24-month outcomes of lens extraction combined with 360-degree circumferential trabeculotomy in patients with progressive pigmentary glaucoma.
Methods: This case series included 32 eyes from 32 patients with progressive pigmentary glaucoma. All patients underwent phacoemulsification combined with gonioscopy-assisted transluminal trabeculotomy (GATT).
Success was defined as an intraocular pressure (IOP) ≤ 18 mm Hg with a 20% reduction in IOP from baseline, without the need for further glaucoma surgery.
Results The mean preoperative IOP was 21.4 (standard deviation 6.3) mm Hg, with an average of 2.2 (standard deviation 1.5) glaucoma medications. At 24 months, the mean IOP had been reduced to 13.0 (standard deviation 3.5) mm Hg (a 39% reduction), and the mean number of medications had been reduced to 0.8 (standard deviation 1.0). The Kaplan-Meier estimated probability of qualified success at 24 months was 75.0% (95% CI: 61.4%–91.6%).
Conclusion: The combination of lens extraction and GATT effectively reduces IOP and medication use in pigmentary glaucoma. By targeting
the source of pigment dispersion, lens extraction can halt the pathological process, making it a highly promising strategy.
