Efficacy Of Gonioscopy Assisted Transluminal Trabeculotomy (Gatt) Alone Or Combined With Phacoemulsification In Management Of Cases Of Plateau Iris Syndrome. A Retrospective Case Series.

To study the IOP lowering effect of GATT whether alone or combined with phacoemulsification on cases of plateau iris syndrome.

We reviewed the records of patients with plateau iris syndrome who underwent GATT alone or combined with phacoemulsification during the period from January 2021to December 2024 at the glaucoma clinic of Kasr Alainy Hospital of Cairo University. 

This is a retrospective case series of 12 eyes of 8 patients with plateau iris syndrome.  GATT was performed as a standalone procedure or in combination with cataract extraction in a tertiary eye centre and the patients completed at least 12 months of follow up. Outcome measures were the change in the IOP, the number of medications, success rate (IOP reduction ≥20% from baseline and IOP between 6 and 21 mmHg, without further glaucoma surgery), and complication rate.

Twelve eyes with plateau iris syndrome were included, seven eyes underwent phacoemulsification and GATT and 5 patients underwent GATT alone. The mean follow up period was 16 ±7.4 months. The preoperative IOP decreased from 24.5 ± 9.3 mmHg on 3.33 medications to 13.09±3.7 mmHg on 0.45 medicationss at the final follow up (p-value =0.004). The final success rate was 91.6% with 58.3 % of patients being off medications..

GATT whether alone or combined with phacoemulsification is a safe and effective method for treatment of cases of plateau iris syndrome.