Evaluation of prolonged use of topical glaucoma medications on gonioscopy-assisted transluminal trabeculotomy outcomes in juvenile open-angle glaucoma.

Purpose: To evaluate the impact of prolonged use of topical glaucoma medications on the surgical outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) in juvenile open-angle glaucoma (JOAG).

Patients and methods: This multicenter retrospective study included 100 eyes of 77 JOAG patients who underwent GATT with at least 12 months of follow-up. Patients were categorized into the short-duration (≤ 1.5 years) and long-duration (> 1.5 years) groups. Intraocular pressure (IOP), glaucoma medications, and complications were recorded at baseline and the final visit. Success was defined as a postoperative IOP ≤ 21 mmHg (criterion A), ≤ 18 mmHg (criterion B), or ≤ 15 mmHg (criterion C). Complete and qualified successes were defined as meeting these criteria without and with medications, respectively.

Results: The mean age of the participants was 23.2 ± 8.6 years with a mean follow-up of 14.2 ± 4.1 months. Qualified and complete success rates for the short-duration and long-duration groups were 98.0 % and 92.0 % (P = 0.369), 80.0 % and 66.0 % (P = 0.322) for criterion A; 92.0 %, and 68.0 % (P = 0.006), 78.0 % and 50.0 % (P = 0.021) for criterion B; 66.0 % and 40.0 % (P = 0.013), 58.0 % and 30.0 % (P = 0.015) for criterion C. The short-duration group had a significantly lower final IOP than the long-duration group (P = 0.011). No significant differences were observed in final medication and complications.

Conclusions: Prolonged use of topical glaucoma medications may reduce the efficacy of GATT in achieving lower IOP in JOAG. Early surgical intervention may contribute to better postoperative outcomes.