Comparison of 1-year surgical outcomes of combined cataract surgery and gonioscopy-assisted transluminal trabeculotomy (GATT) versus cataract surgery and iStent Inject.
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Authors
Mohite, Abhijit Anand
Issue Date
2021-10-01
Journal
Type
Article
Peer-Reviewed Publication
Peer-Reviewed Publication
Keywords
Best corrected visual acuity (BCVA)
Case-control study
Cataract
Combined cataract surgery
Comparative study
Glaucoma
Glaucoma surgery
Gonioscopy-assisted transluminal trabeculotomy (GATT)
Intraocular pressure
iStent
Minimally invasive glaucoma surgery
Minimally invasive surgery
Open-angle glaucoma
Peer-reviewed article
Phacoemulsification
phaco-GATT
phaco-iStent
Retrospective study
Trabeculectomy
Treatment outcome
Case-control study
Cataract
Combined cataract surgery
Comparative study
Glaucoma
Glaucoma surgery
Gonioscopy-assisted transluminal trabeculotomy (GATT)
Intraocular pressure
iStent
Minimally invasive glaucoma surgery
Minimally invasive surgery
Open-angle glaucoma
Peer-reviewed article
Phacoemulsification
phaco-GATT
phaco-iStent
Retrospective study
Trabeculectomy
Treatment outcome
Journal Title
Graefe's Archive for Clinical and Experimental Ophthalmology
Volume
259
Issue
10
Begin page
3035
End page
3044
Abstract
Purpose: Evaluate the efficacy, safety, and complication rates of phacoemulsification cataract surgery when combined with either gonioscopy-assisted transluminal trabeculotomy (GATT) or iStent Inject.
Methods: This is a retrospective case-control study to compare the surgical outcomes of combined phacoemulsification cataract surgery with either GATT (phaco-GATT) or iStent Inject (phaco-iStent). Both groups had at least 1-year follow-up. The primary outcome measures were IOP and number of glaucoma medications (NGMs) at 1 year. Secondary outcomes measures were best corrected visual acuity (BCVA) and intra- or postoperative complications within the first year of follow-up. Success was defined as intraocular pressure (IOP) < 21 mmHg and ≥ 20% reduction in IOP at 1 year regardless of the NGM.
Results: Each group included 37 patients. The median baseline IOP (24 vs 17) and NGM (3 vs 2) were higher in the phaco-GATT group (p < 0.001). Phaco-GATT achieved a 38% (p < 0.0001) reduction in IOP compared to 13.2% (p < 0.001) in the phaco-iStent group at 1-year follow-up. The reduction in IOP and NGM was significantly higher in the phaco-GATT group (p < 0.01). After adjusting for baseline IOP, the reduction in IOP at 12 months was still significantly higher in the phaco-GATT group (p = 0.042). At 1 year, 86.4% of patients in the phaco-GATT group met the success criteria compared to 35.1% in the phaco-iStent group. Safety outcomes were slightly favourable in the phaco-iStent group.
Conclusion: Phaco-GATT and phaco-iStent showed a significant reduction in IOP and NGM, with phaco-GATT having a significantly higher reduction. Phaco-iStent appears to have a higher safety profile and is probably preferable in monocular patients and those with a high risk of bleeding.
Citation
Hamze H, Mohite AA, Pandey P, Sung VCT, Masood I. Comparison of 1-year surgical outcomes of combined cataract surgery and gonioscopy-assisted transluminal trabeculotomy (GATT) versus cataract surgery and iStent Inject. Graefes Arch Clin Exp Ophthalmol. 2021 May 20. doi: 10.1007/s00417-021-05133-z. Epub ahead of print. PMID: 34014384.