ESCRS - PP04.10 - The Efficacy And Refractive Outcomes Of Gonioscopy-Assisted Transluminal Trabeculotomy Combined With Phacoemulsification In Patients With Open-Angle Glaucoma

The Efficacy And Refractive Outcomes Of Gonioscopy-Assisted Transluminal Trabeculotomy Combined With Phacoemulsification In Patients With Open-Angle Glaucoma

Published 2026 - 44th Congress of the ESCRS

Reference: PP04.10 | Type: Free paper | DOI: 10.82333/fsga-z953

Authors: Dr Anılcan Ataç* 1 , Dr Nligün Solmaz 2 , Dr Ayşem Gül Ulukartal 2 , Prof. Dr Feyza Önder 2

1Ophthalmology,Geyve State Hospital,Sakarya,Türkiye, 2Ophthalmology,Haseki Training and Research Hospital,İstanbul,Türkiye

Purpose

To evaluate the efficacy and refractive outcomes of gonioscopy-assisted transluminal trabeculotomy combined
with phacoemulsification (phaco-GATT) in patients with open angle glaucoma (OAG)

Setting

Prospective clinical trial

Methods

This single-centre prospective study included 46 eyes from a total of 46 patients who underwent phaco-GATT
(n = 20) or phacoemulsification alone (n = 26). Postoperative intraocular pressure (IOP), keratometry, axial length (AL)
changes and refractive results were evaluated. Prediction error (PE) in postoperative refraction was calculated by
subtracting the expected refractive value of the implanted intraocular lens from the spherical equivalent (SE) at
postoperative month 3. Refractive surprise (RS) was defined as values outside the ±0.5 diopter (D) range of the PE value.

Results

IOP decreased significantly in the phaco-GATT group (from 22.25 ± 3.34 to 15.75 ± 2.51, p < 0.001); the
decrease in the phacoemulsification group was not significant. A significant decrease in AL was observed in both groups
during the postoperative period (p < 0.001). There was no significant difference between the groups in terms of AL
decrease (-0.11 ± 0.07 mm vs. -0.12 ± 0.13 mm, p = 0.602). No correlation was observed between the decrease in AL
and preoperative IOP or IOP change. RS was detected in 18 of the total 46 cases. The incidence of RS was 40% (8/20)
in the phaco-GATT group and 38.4% (10/26) in the phacoemulsification group. There was no significant difference
between the groups in terms of RS distribution angle (p = 0.916).

Conclusions

Phaco-GATT appears to be an effective and safe option for OAG cases, providing a meaningful reduction
in IOP; it offers refractive outcomes comparable to phacoemulsification alone. According to the secondary results of our
study, a decrease in postoperative AL was detected, independent of changes in IOP. Taking into account similar studies
in the literature, it is thought that the decrease in AL may be more closely related to the final IOP value rather than the
change in IOP.