Efficacy and safety of gonioscopy-assisted transluminal trabeculotomy in glaucoma secondary to fuchs uveitis syndrome: a multicenter study
Graefe's Archive for Clinical and Experimental Ophthalmology, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s00417-026-07394-y
- Dergi Adı: Graefe's Archive for Clinical and Experimental Ophthalmology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest)
- Anahtar Kelimeler: Fuchs uveitis syndrome, Gonioscopy-assisted transluminal trabeculotomy, Uveitic glaucoma
- Gazi Üniversitesi Adresli: Evet
Özet
Purpose: To evaluate the long-term surgical outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) in patients with Fuchs uveitis syndrome (FUS)-associated open-angle glaucoma. Methods: In this multicenter, retrospective, non-comparative study, 34 consecutive eyes of 31 patients with open-angle glaucoma secondary to FUS who underwent GATT at three tertiary referral centers were included. Patients had inadequate intraocular pressure (IOP) control despite maximal medical therapy and a minimum follow-up of 12 months. Complete success was defined as IOP < 21 mmHg with ≥ 20% reduction from baseline without medication. Qualified success was defined as IOP < 21 mmHg with a ≥ 20% reduction, with or without medication, and no need for additional IOP-lowering surgery. Kaplan–Meier survival analysis was performed to assess cumulative success. Results: Mean preoperative IOP was 34.9 ± 8.0 mmHg on 3.5 ± 0.7 medications. The mean follow-up duration was 28 ± 7.4 months (range, 12–48). At final visit, mean IOP decreased to 15.7 ± 4.0 mmHg (52.7% reduction; p < 0.001), and medication burden decreased to 1.1 ± 1.2 (70.4% reduction; p < 0.001). The cumulative probability of qualified success was 88.2%, and complete success was 41.2% at 24 months. Hyphema occurred in 14.7% of eyes, and IOP spikes were observed in 14.7%; all were transient. Four eyes (11.8%) required additional glaucoma surgery. No significant loss of visual acuity was observed. Conclusions: GATT appears to be a safe and effective surgical option for achieving sustained IOP reduction and decreasing medication burden in FUS-associated glaucoma. Its minimally invasive and conjunctival-sparing nature makes it a reasonable initial surgical strategy in selected patients.