{"title":"Bent Ab interno Needle Goniotomy versus Gonioscopy-Assisted Transluminal Trabeculotomy in Primary Open Angle Glaucoma: A Randomized Clinical Trial.","authors":"Gabriel Ayub, Vital Paulino Costa","doi":"10.1097/IJG.0000000000002629","DOIUrl":null,"url":null,"abstract":"<p><strong>Prcis: </strong>Gonioscopy-Assisted Transluminal Trabeculotomy achieved a higher success rate than Bent Ab interno Needle Goniotomy in pseudophakic primary open angle glaucoma eyes at 12-months.</p><p><strong>Purpose: </strong>To evaluate and compare efficacy and safety of standalone Bent Ab interno Needle Goniotomy (BANG) and Gonioscopy-Assisted Transluminal Trabeculotomy (GATT) in pseudophakic primary open angle glaucoma (POAG) eyes.</p><p><strong>Methods: </strong>Parallel, double-arm, 1:1 ratio, single masked, single surgeon, randomized clinical trial. Uncontrolled mild to moderate pseudophakic POAG eyes, defined by visual field mean deviation, were enrolled. Antiglaucoma medication was washed-out before surgery and at 11-months. Patients were followed by 12 months. Surgical success was defined as 6≤IOP≤18 mm Hg and 20% IOP reduction from baseline with (qualified) or without (complete) the use of medication.</p><p><strong>Results: </strong>Twenty-two eyes underwent BANG and 23 underwent GATT. At inclusion, mean IOPs were 21.18±2.87 mm Hg versus 19.87±2.34 mm Hg (P=0.1) under 2.41±0.9 versus 2.35±0.88 medications (P=0.71) in the BANG and GATT groups, respectively. Baseline washout IOPs were 25.55±4.9 mm Hg versus 25.43±4.98 mm Hg in the BANG and GATT groups, respectively (P=0.92). At POD330, IOPs in GATT and BANG groups were 15.62±3.29 mm Hg (-21.38%, P=0.04) and 16.95±2.82 mm Hg (-19.97%, P<0.01), respectively (P=0.16). At POD360, after washout, IOPs were 21.57±11.11 mm Hg (-15.17%, P=0.06) and 24.59±7.94 mm Hg (-3.75%, P=0.53) (P=0.31 between the groups). The mean number of medications used at POD330 was 1.1±1.55 in GATT (-53.19%, P<0.01) and 1.82±1.05 in BANG eyes (-24.48%, P=0.06) (P=0.08 between the groups). GATT eyes had higher complete (60.1% vs. 4.5%, P<0.01) and qualified success rates (64.7% vs. 22.7%, P=0.01) than BANG eyes. Transient hyphema was the most common complication following GATT (56.52%) and BANG (40.9%).</p><p><strong>Conclusion: </strong>GATT eyes achieved higher success rates, lower mean IOPs and required less antiglaucoma medication than BANG eyes after 11-months.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Glaucoma","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/IJG.0000000000002629","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Prcis: Gonioscopy-Assisted Transluminal Trabeculotomy achieved a higher success rate than Bent Ab interno Needle Goniotomy in pseudophakic primary open angle glaucoma eyes at 12-months.
Purpose: To evaluate and compare efficacy and safety of standalone Bent Ab interno Needle Goniotomy (BANG) and Gonioscopy-Assisted Transluminal Trabeculotomy (GATT) in pseudophakic primary open angle glaucoma (POAG) eyes.
Methods: Parallel, double-arm, 1:1 ratio, single masked, single surgeon, randomized clinical trial. Uncontrolled mild to moderate pseudophakic POAG eyes, defined by visual field mean deviation, were enrolled. Antiglaucoma medication was washed-out before surgery and at 11-months. Patients were followed by 12 months. Surgical success was defined as 6≤IOP≤18 mm Hg and 20% IOP reduction from baseline with (qualified) or without (complete) the use of medication.
Results: Twenty-two eyes underwent BANG and 23 underwent GATT. At inclusion, mean IOPs were 21.18±2.87 mm Hg versus 19.87±2.34 mm Hg (P=0.1) under 2.41±0.9 versus 2.35±0.88 medications (P=0.71) in the BANG and GATT groups, respectively. Baseline washout IOPs were 25.55±4.9 mm Hg versus 25.43±4.98 mm Hg in the BANG and GATT groups, respectively (P=0.92). At POD330, IOPs in GATT and BANG groups were 15.62±3.29 mm Hg (-21.38%, P=0.04) and 16.95±2.82 mm Hg (-19.97%, P<0.01), respectively (P=0.16). At POD360, after washout, IOPs were 21.57±11.11 mm Hg (-15.17%, P=0.06) and 24.59±7.94 mm Hg (-3.75%, P=0.53) (P=0.31 between the groups). The mean number of medications used at POD330 was 1.1±1.55 in GATT (-53.19%, P<0.01) and 1.82±1.05 in BANG eyes (-24.48%, P=0.06) (P=0.08 between the groups). GATT eyes had higher complete (60.1% vs. 4.5%, P<0.01) and qualified success rates (64.7% vs. 22.7%, P=0.01) than BANG eyes. Transient hyphema was the most common complication following GATT (56.52%) and BANG (40.9%).
Conclusion: GATT eyes achieved higher success rates, lower mean IOPs and required less antiglaucoma medication than BANG eyes after 11-months.
结论：腹腔镜下经腔内小梁切开术治疗12个月原发性开角型青光眼的成功率高于弯Ab针间切开术。目的：评价和比较单刀弯Ab针间切开术（BANG）和刀镜辅助下腔内小梁切开术（GATT）治疗原发性假性开角型青光眼（POAG）的疗效和安全性。方法：平行、双臂、1:1比例、单蒙面、单手术、随机临床试验。以视野平均偏差定义的未控制的轻度至中度假性POAG眼被纳入研究。抗青光眼药物在手术前和11个月时被清除。随访12个月。手术成功的定义是（合格）或（完全）使用药物后IOP较基线降低20%。结果：BANG 22眼，GATT 23眼。纳入时，BANG组和GATT组的平均IOPs分别为21.18±2.87 mm Hg和19.87±2.34 mm Hg (P=0.1)，分别为2.41±0.9和2.35±0.88 （P=0.71）。基线洗脱IOPs在BANG组和GATT组分别为25.55±4.9 mm Hg和25.43±4.98 mm Hg （P=0.92）。在POD330时，GATT组和BANG组的眼压分别为15.62±3.29 mm Hg （-21.38%， P=0.04）和16.95±2.82 mm Hg（-19.97%）。结论：GATT组在11个月后的青光眼成功率较高，平均眼压较BANG组低，所需抗青光眼药物较少。
期刊介绍：
The Journal of Glaucoma is a peer reviewed journal addressing the spectrum of issues affecting definition, diagnosis, and management of glaucoma and providing a forum for lively and stimulating discussion of clinical, scientific, and socioeconomic factors affecting care of glaucoma patients.
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