Ultra biomicroscopy findings in goniotomy-assisted transluminal trabeculotomy — a case report
Abstract
Background: Goniotomy-assisted transluminal trabeculotomy (GATT) is a minimally invasive technique that avoids conjunctival incision and is guided by light through the Schlemm’s canal using a microcatheter with an illuminated tip. This technique decreases intraocular pressure (IOP) by improving flow through the Schlemm’s canal. We present two cases of glaucoma patients who underwent GATT surgery for IOP control.
Cases presentation: The first case is a 19-year patient with juvenile glaucoma that underwent GATT because of uncontrolled IOP with a successful outcome. The second case is a 64-year female patient with primary open-angle glaucoma who underwent GATT surgery because of uncontrolled IOP who presented a cyclodialysis secondary to the procedure, with an adequate IOP after surgery. Ultra biomicroscopy (UBM) was used to assess the anatomical changes associated with surgery.
Conclusions: Goniotomy-assisted transluminal trabeculotomy is a safe technique but not free of risks and potential complications. Ultra biomicroscopy is a diagnostic aid that allows us to provide valuable information to evaluate the pre-surgical, post-surgical anatomy and possible complications to follow-up and guide the management
in required cases.
Keywords: glaucomaintraocular pressuregoniotomy-assisted transluminal trabeculotomy
References
- Richter GM, Coleman AL. Minimally invasive glaucoma surgery: current status and future prospects. Clin Ophthalmol. 2016; 10: 189–206.
- Grover D, Godfrey D, Smith O, et al. Gonioscopy-Assisted Transluminal Trabeculotomy, Ab Interno Trabeculotomy. Ophthalmology. 2014; 121(4): 855–861.
- Shi Y, Wang H, Yin J, et al. Microcatheter-assisted trabeculotomy versus rigid probe trabeculotomy in childhood glaucoma. Br J Ophthalmol. 2016; 100(9): 1257–1262.
- Grover DS, Smith O, Fellman RL, et al. Gonioscopy assisted transluminal trabeculotomy: an ab interno circumferential trabeculotomy for the treatment of primary congenital glaucoma and juvenile open angle glaucoma. Br J Ophthalmol. 2015; 99(8): 1092–1096.
- Lim ME, Dao JB, Freedman SF. 360-Degree Trabeculotomy for Medically Refractory Glaucoma Following Cataract Surgery and Juvenile Open-Angle Glaucoma. Am J Ophthalmol. 2017; 175: 1–7.
- Shakrawal J, Bali S, Sidhu T, et al. Randomized Trial on Illuminated-Microcatheter Circumferential Trabeculotomy Versus Conventional Trabeculotomy in Congenital Glaucoma. Am J Ophthalmol. 2017; 180: 158–164.
- Sarkisian SR. An illuminated microcatheter for 360-degree trabeculotomy [corrected] in congenital glaucoma: a retrospective case series. J AAPOS. 2010; 14(5): 412–416.
- Verner-Cole EA, Ortiz S, Bell NP, et al. Subretinal suture misdirection during 360 degrees suture trabeculotomy. Am J Ophthalmol. 2006; 141(2): 391–392.
- Koga-Nakamura, W. Ultrabiomicroscopía y ciclodiálisis. Rev Mex Oftalmol. 2007; 81(6): 326–333.