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Magacho L, Franco CGVDS, I EA, Pereira ACA, Teno B, Lucena-Neto F, Faria BM, Vieira JM, Vianello MP, Kanadani FN. Gonioscopy-Assisted Transluminal Trabeculotomy Outcomes Under Different Levels of Glaucoma Severity: A Multicenter, Comparative Study. Am J Ophthalmol 2024; 264:75-84. [PMID: 38432563 DOI: 10.1016/j.ajo.2024.02.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/22/2024] [Accepted: 02/22/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE To evaluate the outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) under different levels of glaucoma severity. DESIGN Retrospective, multicenter, before-and-after study. METHODS One eye from all primary open-angle glaucoma patients who underwent GATT combined with cataract surgery (Phaco-GATT) or GATT stand-alone with 12 months of follow-up were included and divided according to glaucoma severity (mild = GI, moderate = GII, and advanced = GIII) and the outcomes compared. RESULTS A total of 270 eyes were included: 90 in GI, 75 in GII, and 105 in GIII. The IOP was reduced from 18.6 ± 6.0 mm Hg in GI, 19.7 ± 6.4 mm Hg in GII, and 21.0 ± 7.9 mm Hg in GIII, preoperatively, to 11.9 ± 2.6 mm Hg in GI, 11.8 ± 2.1 mm Hg in GII, and 11.9 ± 3.0 mm Hg in GIII at 12 months postoperatively (P < .001 for all). The number of hypotensive ocular medications were reduced from 2.7 ± 1.0 in GI, 3.1 ± 0.8 in GII, and 3.2 ± 1.2 in GIII to 0.6 ± 0.9 in GI, 1.0 ± 1.1 in GII, and 1.2 ± 1.1 in GIII at the last postoperative visit (P < .001 for all). Relative success was achieved, at 1 year, in 93.8% of the eyes in GI, 89.0% in GII, and 88.1% in GIII (P = .3). Complete success was achieved in 61.8% of the eyes in GI, 43.8% in GII, and 37.6% in GIII (P = .007). No serious adverse event was observed in any group. CONCLUSIONS GATT is a safe and effective procedure in glaucoma, regardless of its preoperative severity.
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Affiliation(s)
- Leopoldo Magacho
- From the Department of Ophthalmology, Federal University of Goiás (CEROF-UFG) (L.M., C.G.V.d.S.F., E.A.I.), Goiânia, Goiás, Brazil; VER Hospital (L.M.), Goiânia, Goiás, Brazil.
| | | | - Eduardo Akio I
- From the Department of Ophthalmology, Federal University of Goiás (CEROF-UFG) (L.M., C.G.V.d.S.F., E.A.I.), Goiânia, Goiás, Brazil
| | - Ana Cláudia Alves Pereira
- Department of Ophthalmology, Federal University of Mato Grosso do Sul (A.C.A.P.), Campo Grande, Mato Grosso do Sul, Brazil; Eye Hospital of Mato Grosso do Sul (A.C.A.P.), Campo Grande, Mato Grosso do Sul, Brazil
| | - Bruno Teno
- D'Olhos Day Hospital, São José do Rio Preto (B.T., F.L.-N.), São Paulo, Brazil
| | | | - Bruno M Faria
- Marco Rey Ophthalmology Institute (B.M.F.), Natal, Rio Grande do Norte, Brazil; Department of Ophthalmology, Federal University of Rio Grande do Norte (B.M.F.), Natal, Rio Grande do Norte, Brazil
| | - Júlia Maggi Vieira
- Glaucoma Institute (J.M.V., F.N.K.), Belo Horizonte, Minas Gerais, Brazil
| | - Marcos Pereira Vianello
- Department of Ophthalmology, Federal University of São Paulo, São Paulo (M.P.V., F.N.K.), São Paulo, Brazil
| | - Fábio N Kanadani
- Glaucoma Institute (J.M.V., F.N.K.), Belo Horizonte, Minas Gerais, Brazil; Department of Ophthalmology, Federal University of São Paulo, São Paulo (M.P.V., F.N.K.), São Paulo, Brazil; Department of Ophthalmology, Mayo Clinic (F.N.K.), Jacksonville, Florida, USA
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Zhang Y, Yu P, Zhang Y, Sugihara K, Zhu X, Zhang Y, Yang X, Li X, Liu Y, Zhang H, Yan X, Zhang H, Lin F, Song Y, Gao X, Yuan H, Tang G, Zhou W, Fan S, Dang G, Tang L, Chen W, Wang N, Park KH, Barton K, Aung T, Lam DSC, Weinreb RN, Xie L, Tanito M, Zeng L, Zhang X. Influence of Goniotomy Size on Treatment Safety and Efficacy for Primary Open-Angle Glaucoma: A Multicenter Study. Am J Ophthalmol 2023; 256:118-125. [PMID: 37573988 DOI: 10.1016/j.ajo.2023.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 08/15/2023]
Abstract
PURPOSE To compare the efficacy and safety of 120-, 240-, and 360-degree goniotomy (GT) with or without phacoemulsification with intraocular lens implantation (PEI) for patients with primary open-angle glaucoma (POAG). DESIGN Multicenter, retrospective, comparative, nonrandomized interventional study. METHODS Patients diagnosed with POAG who underwent GT with or without PEI were included, and divided into 6 groups: 1) standalone 120-degree GT (120GT); 2) standalone 240-degree GT (240GT); 3) standalone 360-degree GT (360GT); 4) PEI + 120GT; 5) PEI + 240GT; and 6) PEI + 360GT. Data on intraocular pressure (IOP), the number of ocular hypotensive medications, and complications were collected and compared. Success was defined as a postoperative IOP within the range of 6 to 18 mm Hg and a 20% reduction from baseline without further glaucoma surgery. Complete success and qualified success were defined as the above without and with ocular hypotensive medications, respectively. RESULTS Three hundred eight eyes of 231 patients were included with a mean follow-up of 14.4 ± 8.6 months (6.0-48.0 months). There were no significant differences in the reductions in IOP and number of medications and cumulative survival probability for complete and qualified success rates among the 3 groups of standalone GT and PEI + GT. The 360GT group had the highest proportion of hyphema with or without PEI. CONCLUSIONS 120GT, 240GT, and 360GT with or without PEI showed similar efficacy in reducing IOP and medications used in POAG. 360GT with or without PEI was more likely to cause hyphema compared with 120GT or 240GT. 120GT with or without PEI was sufficient for treating POAG with or without cataract..
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Affiliation(s)
- Yu Zhang
- From the State Key Laboratory of Ophthalmology (Yu Zhang, Yingzhe Zhang, F.L., Y.S., X.G., W.C., Xiulan Zhang), Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Ping Yu
- Department of Ophthalmology (P.Y., L.Z.), Chengdu First People's Hospital, Chengdu, Sichuan, China
| | - Yingzhe Zhang
- From the State Key Laboratory of Ophthalmology (Yu Zhang, Yingzhe Zhang, F.L., Y.S., X.G., W.C., Xiulan Zhang), Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Kazunobu Sugihara
- Department of Ophthalmology (K.S., M.T.), Shimane University Faculty of Medicine, Izumo, Japan
| | - Xiaomin Zhu
- Department of Ophthalmology (X.Z., L.X.), The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yao Zhang
- Department of Ophthalmology (Yao Zhang, L.T.), West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xiao Yang
- Jinan Mingshui Eye Hospital (X.Y., X.L., S.F.), Jinan, Shandong, China
| | - Xiaoyan Li
- Department of Ophthalmology (X.L.), Handan City Eye Hospital (The Third Hospital of Handan), Handan, Hebei, China
| | - Yacong Liu
- Cangzhou Aier Eye Hospital (Y.L., W.Z.), Aier Eye Hospital Group, Cangzhou, Hebei, China
| | - Hengli Zhang
- Department of Ophthalmology (Hengli Zhang, X.Y., G.T.), Shijiazhuang People's Hospital, Shijiazhuang, Hebei, China
| | - Xiaowei Yan
- Department of Ophthalmology (Hengli Zhang, X.Y., G.T.), Shijiazhuang People's Hospital, Shijiazhuang, Hebei, China
| | - Hengkai Zhang
- Department of Ophthalmology (Hengkai Zhang, H.Y.), The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Fengbin Lin
- From the State Key Laboratory of Ophthalmology (Yu Zhang, Yingzhe Zhang, F.L., Y.S., X.G., W.C., Xiulan Zhang), Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Yunhe Song
- From the State Key Laboratory of Ophthalmology (Yu Zhang, Yingzhe Zhang, F.L., Y.S., X.G., W.C., Xiulan Zhang), Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Xinbo Gao
- From the State Key Laboratory of Ophthalmology (Yu Zhang, Yingzhe Zhang, F.L., Y.S., X.G., W.C., Xiulan Zhang), Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Huiping Yuan
- Department of Ophthalmology (Hengkai Zhang, H.Y.), The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Guangxian Tang
- Department of Ophthalmology (Hengli Zhang, X.Y., G.T.), Shijiazhuang People's Hospital, Shijiazhuang, Hebei, China
| | - Wenzong Zhou
- Cangzhou Aier Eye Hospital (Y.L., W.Z.), Aier Eye Hospital Group, Cangzhou, Hebei, China
| | - Sujie Fan
- Department of Ophthalmology (X.L.), Handan City Eye Hospital (The Third Hospital of Handan), Handan, Hebei, China
| | - Guangfu Dang
- Department of Ophthalmology (G.D.), The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China
| | - Li Tang
- Department of Ophthalmology (Yao Zhang, L.T.), West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Weirong Chen
- From the State Key Laboratory of Ophthalmology (Yu Zhang, Yingzhe Zhang, F.L., Y.S., X.G., W.C., Xiulan Zhang), Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Ningli Wang
- Beijing Tongren Eye Center (N.W.), Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ki Ho Park
- Department of Ophthalmology (K.H.P.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Keith Barton
- NIHR Biomedical Research Centre (K.B.), Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology, London, United Kingdom
| | - Tin Aung
- Singapore Eye Research Institute (T.A.), Singapore National Eye Center, Singapore, Republic of Singapore
| | - Dennis S C Lam
- International Eye Research Institute of The Chinese University of Hong Kong (Shenzhen) (D.S.C.L.), Shenzhen, China
| | - Robert N Weinreb
- Hamilton Glaucoma Center (R.N.W.), Viterbi Family Department of Ophthalmology, and Shiley Eye Institute, University of California San Diego, La Jolla, California, USA
| | - Lin Xie
- Department of Ophthalmology (X.Z., L.X.), The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Masaki Tanito
- Department of Ophthalmology (K.S., M.T.), Shimane University Faculty of Medicine, Izumo, Japan
| | - Liuzhi Zeng
- Department of Ophthalmology (P.Y., L.Z.), Chengdu First People's Hospital, Chengdu, Sichuan, China.
| | - Xiulan Zhang
- From the State Key Laboratory of Ophthalmology (Yu Zhang, Yingzhe Zhang, F.L., Y.S., X.G., W.C., Xiulan Zhang), Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China.
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