Comparison Of Standalone Gatt Versus Omni Surgical System In Primary Open-Angle Glaucoma
Published 2026 - 44th Congress of the ESCRS
Reference: PP04.07 | Type: Free paper | DOI: 10.82333/qx20-he88
Authors: A/Prof. Mehmet Ozgur Cubuk* 1 , Dr Rukiye Kilic Ucgul 2 , A/Prof. Ahmet Yucel Ucgul 2 , Dr Melissa Chin 3 , Dr Valence Jordan 3 , Dr Tajwar Nasir 3 , A/Prof. Jenny Kirkby 3 , A/Prof. Matthew Kinsella 3 , A/Prof. Anna Mead 3 , Dr Hiten Sheth 3 , Dr Arul Rajammal 3 , Dr Asifa Shaikh 3
1Ophthalmology,Cam and Sakura City Hospital,Istanbul,Türkiye, 2Ophthalmology,Ahi Evran University, Kirsehir Training and Research Hospital,Kirsehir,Türkiye, 3Ophthalmology,Buckinghamshire Healthcare NHS Trust,Buckinghamshire ,United Kingdom
Purpose
To evaluate and compare the 12-month clinical outcomes of standalone gonioscopy-assisted transluminal trabeculotomy (GATT) and the OMNI Surgical System in individuals with primary open-angle glaucoma (POAG).
Setting
This retrospective comparative analysis included 77 eyes from 77 patients with POAG who underwent either circumferential GATT alone (n = 44) or the OMNI procedure (n = 33).
Methods
Eligible cases had uncontrolled intraocular pressure (IOP ≥20 mmHg) despite maximal medical therapy or demonstrated intolerance to antiglaucoma medications. Complete success was defined as achieving an IOP ≤16 mmHg with at least a 25% reduction from baseline without medications or additional surgery, whereas qualified success permitted continued medication use. Primary outcome measures were surgical success rates, IOP levels, medication burden, and postoperative complications.
Results
At 12 months, mean IOP reduction was similar between groups: −7.9 ± 4.7 mmHg (33.6%) in the GATT cohort and −8.1 ± 3.4 mmHg (36.6%) in the OMNI cohort (p = 0.87). Complete success occurred more frequently following GATT (18.1%) than OMNI (9.0%) (p < 0.001). Qualified success rates did not differ significantly (70.5% vs. 63.6%; p = 0.476). Hyphema was the most common postoperative event and was observed more often after GATT (43.1%) compared with OMNI (18.1%) (p = 0.001); all cases resolved spontaneously. Transient postoperative IOP elevations were noted in 2.2% of GATT eyes and 9% of OMNI eyes (p = 0.208), with no lasting consequences.
Conclusions
Both surgical approaches produced meaningful and sustained reductions in IOP with acceptable safety profiles in POAG patients. GATT demonstrated a higher rate of complete success, whereas OMNI was associated with a lower incidence of hyphema. Thus, GATT may be advantageous when medication-free pressure control is desired, while OMNI may be preferable for individuals with increased bleeding risk.