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Purpose <p>To evaluate the impact of preoperative antiglaucoma medication duration on the surgical outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) in patients with open-angle glaucoma (OAG).</p> Design <p>Retrospective comparative study.</p> Patients and Methods <p>This retrospective case series included 64 eyes from patients diagnosed with primary OAG or pseudoexfoliative glaucoma who underwent 360-degree GATT. Patients were categorized into three groups based on the duration of preoperative medication use: short-term (&lt; 2&#xa0;years), moderate-term (2–5&#xa0;years), and long-term (&gt; 5&#xa0;years). Intraocular pressure (IOP) was measured using Goldmann applanation tonometry during follow-up visits, and surgical success was defined based on IOP reduction criteria. The number of glaucoma medications, best-corrected visual acuity, and postoperative complications were also recorded. Kaplan–Meier survival analysis was used to assess success rates.</p> Results <p>The mean follow-up duration was 17.2 ± 6.8&#xa0;months. The short-term, moderate-term, and long-term groups achieved significant IOP reductions (<i>p</i> &lt; 0.001), with final mean IOPs of 13.2 ± 4.7&#xa0;mmHg, 17.7 ± 6.4&#xa0;mmHg, and 18.1 ± 6.9&#xa0;mmHg, respectively (<i>p</i> = 0.002). The mean number of postoperative medications decreased significantly across all groups (<i>p</i> = 0.032). Qualified success rates were 92.3%, 77.2%, and 79.3% for the short-term, moderate-term, and long-term groups, respectively, while complete success rates were 76.9%, 63.6%, and 58.6%.</p> Conclusion <p>GATT effectively lowers IOP in patients with OAG, though prolonged preoperative medication use is associated with reduced surgical success and higher postoperative medication dependence. Early surgical intervention may enhance long-term outcomes for patients with a history of escalating medication regimens.</p>

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Effect of preoperative antiglaucoma medication duration on surgical outcomes of gonioscopy-assisted transluminal trabeculotomy in open-angle glaucoma

  • 期刊论文

  • 发表日期：

    2025年6月20日

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  • Rukiye Kilic Ucgul,
  • Ahmet Yucel Ucgul,
  • Mehmet Ozgur Cubuk

摘要

Purpose

To evaluate the impact of preoperative antiglaucoma medication duration on the surgical outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) in patients with open-angle glaucoma (OAG).

Design

Retrospective comparative study.

Patients and Methods

This retrospective case series included 64 eyes from patients diagnosed with primary OAG or pseudoexfoliative glaucoma who underwent 360-degree GATT. Patients were categorized into three groups based on the duration of preoperative medication use: short-term (< 2 years), moderate-term (2–5 years), and long-term (> 5 years). Intraocular pressure (IOP) was measured using Goldmann applanation tonometry during follow-up visits, and surgical success was defined based on IOP reduction criteria. The number of glaucoma medications, best-corrected visual acuity, and postoperative complications were also recorded. Kaplan–Meier survival analysis was used to assess success rates.

Results

The mean follow-up duration was 17.2 ± 6.8 months. The short-term, moderate-term, and long-term groups achieved significant IOP reductions (p < 0.001), with final mean IOPs of 13.2 ± 4.7 mmHg, 17.7 ± 6.4 mmHg, and 18.1 ± 6.9 mmHg, respectively (p = 0.002). The mean number of postoperative medications decreased significantly across all groups (p = 0.032). Qualified success rates were 92.3%, 77.2%, and 79.3% for the short-term, moderate-term, and long-term groups, respectively, while complete success rates were 76.9%, 63.6%, and 58.6%.

Conclusion

GATT effectively lowers IOP in patients with OAG, though prolonged preoperative medication use is associated with reduced surgical success and higher postoperative medication dependence. Early surgical intervention may enhance long-term outcomes for patients with a history of escalating medication regimens.