GATT-First Surgical Sequence Reduces Complications in Combined Phacoemulsification–GATT Surgery for Glaucoma
Erdem Yüksel, Zübeyir Yozgat, Berire Şeyma Durmuş Ece, Gizem İlayda Dumlupınar, Mehmed Uğur Işık, Kaan ÖzkanPrécis:
This study highlights the importance of surgical sequencing in combined procedures, suggesting that the GATT-first sequence is safer and more reliable, especially for less experienced surgeons.
Purpose:
To evaluate the impact of the surgical sequence in combined phacoemulsification (PHACO) and gonioscopy-assisted transluminal trabeculotomy (GATT) on intraocular pressure (IOP), medication use, glaucoma progression, and complication rates in patients with moderate-to-severe open-angle glaucoma and cataract.
Methods:
This retrospective comparative study included 73 eyes of 73 patients who underwent combined PHACO and GATT surgery. Patients were divided into two groups based on the surgical sequence: PHACO performed first (Group 1, n=37) or GATT performed initially (Group 2, n=36). IOP, anti-glaucoma medications use, retinal nerve fiber layer (RNFL) thickness, and intraoperative and postoperative complications were evaluated over 12 months.
Results:
Preoperative IOP decreased from 26.6±7.9 mmHg to 10.9±2.8 mmHg and from 28±6.3 mmHg to 12.8±2.8 mmHg in Group 1 and Group 2 (
Conclusions:
The surgical sequence in combined PHACO-GATT does not affect IOP reduction or medication number but significantly impacts complication rates. Performing GATT first minimizes intraoperative complications and results in a higher rate of complication-free outcomes, suggesting it as a safer approach for combined surgeries, especially for beginners.