Hemi-Gonioscopic-Assisted Transluminal Trabeculotomy Combined with Direct Ab-Interno viscoelastic Canaloplasty | ASCRS
Presentation
Hemi-Gonioscopic-Assisted Transluminal Trabeculotomy Combined with Direct Ab-Interno viscoelastic Canaloplasty
May 2020
Meeting: 2020 Virtual Annual Meeting
Session: SPS-105 Minimally Invasive Glaucoma Surgery: Viscocanalostomy, Combined Procedures, Outcomes
Authors: Gavin S. Docherty, FRCSC, Patrick Gooi MD
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Purpose
To describe a novel minimally invasive surgical technique for treatment of open-angle glaucoma. Initial papers describe gonioscopic-transluminal trabeculotomy as a circumferential procedure. The authors describe a novel procedure with 180-degree trabeculotomy followed by viscoelastic canaloplasty (viscocanaloplasty).

Methods
This was a pilot project describing initial results in a small case series (n=8) of patients undergoing hemi-gonioscopic-assisted transluminal trabeculotomy (Hemi GATT) with direct viscocanaloplasty.

Results
This was a pilot project (n=26) of patients undergoing hemi-gonioscopic-assisted transluminal trabeculotomy (Hemi GATT) with direct viscocanaloplasty. The mean age was 69 years (Range 24-87). Preoperatively the mean intraocular pressure (IOP) was 16 mmHg (Range 7-37) and patients were on an average of 2.8 IOP lowering drops. Average daily dose of diamox was 466mg (n=11). IOP lowering was significantly lower at 6 months follow up (p=0.05) with a mean IOP of 13 mmHg. IOP lowering medications were reduced significantly to an average of 1.6. Only one patient remained on diamox (375 mg daily). One patient developed CME and two patients had IOP spikes that were managed medically.

Conclusion
The results suggest that Hemi-GATT with direct viscocanaloplasty provides significant reductions in IOP as well as reduces reliance on oral diamox and topical IOP lowering medications. Ongoing evaluation is required to establish safety and efficacy especially when compared to hemi-GATT alone or circumferential GATT.
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This presentation is from the session "SPS-105 Minimally Invasive Glaucoma Surgery: Viscocanalostomy, Combined Procedures, Outcomes" from the 2020 ASCRS Virtual Annual Meeting held on May 16-17, 2020.

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