Long-Term Outcomes Of Gonioscopy-Assisted Transluminal Trabeculotomy (Gatt) In Uveitic Glaucoma

To evaluate long-term intraocular pressure (IOP), inflammatory control, visual outcomes, and success rates following gonioscopy-assisted transluminal trabeculotomy (GATT) in patients with uveitic glaucoma.

Tertiary referral academic medical center.

This retrospective single-center study included 35 eyes of 30 patients with uveitic glaucoma who underwent GATT. Collected outcomes included IOP, glaucoma medications, surgical success, uveitic flare-ups, corticosteroid and immunomodulatory therapy use, central macular thickness (CMT), visual acuity, retinal nerve fiber layer (RNFL) thickness, and visual field mean deviation (MD), through postoperative year (POY) 4.

Mean age was 44.2±20.4 years with 33.0±13.6 months follow-up. Preoperative IOP was 25.4±7.2 mmHg on 4.4±0.8 medications. IOP decreased to 11.1±3.4 mmHg at POY1 and remained stable through POY4 (12.8±5.6), with medications reduced to ≤0.5 beyond year 1. Surgical success was 90% at POY1 and 68% at POY4; 14.2% required additional surgery. Visual acuity improved and remained stable. RNFL and VF were preserved. CMT remained stable, flare-ups decreased, topical steroid use declined, systemic steroids were stable, and immunomodulatory therapy increased consistent with steroid-sparing management.

GATT achieved sustained IOP reduction and significant medication sparing without increased uveitic activity or macular edema over long-term follow-up, supporting its role as an effective, inflammation-compatible surgical option in uveitic glaucoma.