Factors Associated With Gonioscopy-Assisted Transluminal Trabeculotomy (GATT) Complications and Failure in Children.
Am J Ophthalmol
; 241: 168-178, 2022 09.
Article
em En
| MEDLINE
| ID: mdl-35551908
ABSTRACT
PURPOSE:
To identify the factors associated with the complications and failure of gonioscopy-assisted transluminal trabeculotomy (GATT) in children.DESIGN:
Retrospective case series.METHODS:
This study was conducted in an institutional setting in a pediatric population (aged <18 years) who had undergone GATT. Records were reviewed, and pre- and postoperative intraocular pressures (IOP), extent of angle treated, medications, complications, and failure were recorded. Failure was defined as IOP >21 mm Hg or <5 mm Hg, absence of at least 20% IOP reduction, performance of additional IOP-lowering surgery, or loss of light perception vision.RESULTS:
A total of 74 eyes of 57 patients were included (mean age, 7.1 years). Over a median follow-up period of 28.5 months, 36 eyes (48.6%) failed. IOP spikes occurred in 25 eyes (33.8%) and were a significant risk factor for failure (hazard ratio [HR] = 2.17; P = .0207). Postoperative hyphema was a significant risk factor for IOP spike (HR = 4.13, P = .003) but not for failure (HR = 0.7, P = .2977). The risk of IOP spike was lowest in eyes treated with nonsteroidal anti-inflammatory drugs (NSAIDs; HR = 0.27, P = .0016). The risk of failure increased significantly in eyes that received topical corticosteroids (compared to NSAIDs; HR = 5.72, P = .0005), in eyes with <360â incisions (HR = 4.69, P < .0001), and in younger children.CONCLUSIONS:
GATT is a reasonably effective procedure in childhood glaucoma. Postoperatively, the use of topical NSAIDs (without corticosteroid) may decrease the risk of failure. Eyes with IOP spikes without hyphema are at the highest risk for failure.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Trabeculectomia
/
Glaucoma de Ângulo Aberto
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Child
/
Humans
Idioma:
En
Revista:
Am J Ophthalmol
Ano de publicação:
2022
Tipo de documento:
Article