Gonioscopy Assisted Transluminal Trabeculotomy (Gatt) Alone Or Combined With Phacoemulsification: A Systematic Review And Bibliometric Analysis
Published 2024 - 42nd Congress of the ESCRS
Reference: PO1064 | Type: Free paper | DOI: 10.82333/tee9-xj51
Authors: Tomas Galvez-Olortegui* 1 , Isabel Silva-Ocas 2 , Esteban Vergara-de la Rosa 3 , Edward Chavez-Cruzado 4 , Jaime Gonzales-Saldaña 5 , Carmen Burgueño-Montañes 6 , Jose Galvez-Olortegui 6
1Evidence Based Ophthalmology Unit (Oftalmoevidencia),Scientia Clinical and Epidemiological Research Institute,Trujillo,Peru;Centro de Excelencia en Glaucoma,Clinica GO-Vision,Lima,Peru;Department of Ophthalmology,Hospital Nacional Guillermo Almenara Irigoyen,Lima,Peru, 2Evidence Based Ophthalmology Unit (Oftalmoevidencia),Scientia Clinical and Epidemiological Research Institute,Trujillo,Peru;Centro de Excelencia en Glaucoma,Clinica GO-Vision,Lima,Peru, 3Grupo Regional de Evidencia en Otorrinolaringología (GRE-ORL),Scientia Clinical and Epidemiological Research Institute,Trujillo,Peru;Hospital Regional Docente de Trujilo,Trujillo,Peru, 4Evidence Generation and Epidemiologic Suverillance Unit,Scientia Clinical and Epidemiological Research Institute,Trujillo,Peru;Facultad de Medicina Humana,Universidad Privada Antenor Orrego,Trujillo,Peru, 5Evidence Generation and Epidemiologic Suverillance Unit,Scientia Clinical and Epidemiological Research Institute,Trujillo,Peru;Hospital II Lima Norte Callao - Luis Negreiros Vega,Lima,Peru, 6Evidence Based Ophthalmology Unit (Oftalmoevidencia),Scientia Clinical and Epidemiological Research Institute,Trujillo,Peru;Service of Ophthalmology,Hospital Universitario Central de Asturias,Oviedo,Spain
Purpose
To assess the safety, effectivity and worldwide use of Gonioscopy assisted transluminal trabeculotomy (GATT) (alone or combined with phacoemulsification) in patients with open angle glaucoma (OAG) through a systematic review and bibliometric analysis.
Setting
Glaucoma is a term describing a group of ocular disorders with multi-factorial etiology. The most frequent type of glaucoma is the open angle glaucoma (OAG).
During the past years, several studies have reported effectivity and safety of minimally invasive glaucoma surgery (MIGS) techniques. Gonioscopy-assisted transluminal trabeculotomy (GATT) was described by Grover et al. in 2014. Positive results have been reported about intraocular pressure (IOP) control and low complication rates.
Methods
A systematic search was performed in PubMed/Medline, Scopus, Web of Science, and Embase, Cochrane, and Scielo until February-2024. Eligible articles were independently screened, and quality assessed by 2 reviewers. Randomized clinical trials (RCT) and non-randomized observational studies (cohorts, case and control, and case series) with at least 12 months of follow up were included. Outcomes of effectivity (surgical success, IOP reduction, changes in number of medications, changes in visual acuity) and safety (adverse events) were summarized according to the surgical techniques used in the study (alone or combined with phacoemulsification): GATT/PhacoGATT alone, GATT/PhacoGATT vs trabeculectomy, and GATT/PhacoGATT vs other MIGS/MIBS.
Results
40 articles were selected. Most of articles included, reported the results of GATT alone or in combination with phacoemulsification. Reports of GATT vs trabeculectomy showed a benefit of IOP reduction in patients with trabeculectomy, however GATT is a less invasive procedure. GATT vs MIGS (ABiC, iStent, KDB) or vs MIBS showed variable results. In before-after series, GATT surgery seemed effective in lowering both IOP and glaucoma drug use, with a good safety profile: hyphema was the most frequent complications and no cases of infection were reported. GATT has been performed in America (USA, Canada and Latin America), Asia, Africa or European countries like United Kingdom, Switzerland, Italy, Romania, and Poland.
Conclusions
GATT is an effective and safety procedure in terms of IOP reduction, number of medications, and visual acuity, alone or in combination with phacoemulsification. GATT is a worldwide performed procedure (high- and low-income countries)