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Abstract：
BACKGROUND: This retrospective study aimed to evaluate the efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) in Chinese patients with primary congenital glaucoma (PCG) and identify factors influencing surgical success.
METHODS: Fourteen patients (24 eyes) diagnosed with PCG who underwent gonioscopy-assisted transluminal trabeculotomy were recruited, and data on intraocular pressure (IOP), antiglaucoma medication, surgery-related complications, and additional treatments were collected during preoperative and postoperative visits. Surgical success was defined as IOP ≤ 21 mmHg and a reduction of > 30% from baseline, with (partial success) or without (complete success) antiglaucoma medication.
RESULTS: Mean preoperative IOP was 30.41 ± 6.09 mmHg. At the final visit, mean IOP reduction was 16.1 ± 9.1 mmHg (52%), and 19 of 24 eyes were topical medication-free. IOP was significantly decreased at each postoperative visit compared with baseline (P < 0.05 for all time points). Cumulative proportions of complete and partial success were 79.2% and 95.8%, respectively, at three years postsurgery. Patients without prior antiglaucoma procedures, without postoperative IOP spikes, and those undergoing complete trabeculotomy exhibited improved surgical prognosis. No permanent vision-threatening complications occurred in the 24 eyes by the end of the respective follow-ups.
CONCLUSIONS: Gonioscopy-assisted transluminal trabeculotomy emerged as a safe and effective procedure for PCG treatment, characterized by outstanding IOP reduction efficacy and high surgical success rates.
METHODS: Fourteen patients (24 eyes) diagnosed with PCG who underwent gonioscopy-assisted transluminal trabeculotomy were recruited, and data on intraocular pressure (IOP), antiglaucoma medication, surgery-related complications, and additional treatments were collected during preoperative and postoperative visits. Surgical success was defined as IOP ≤ 21 mmHg and a reduction of > 30% from baseline, with (partial success) or without (complete success) antiglaucoma medication.
RESULTS: Mean preoperative IOP was 30.41 ± 6.09 mmHg. At the final visit, mean IOP reduction was 16.1 ± 9.1 mmHg (52%), and 19 of 24 eyes were topical medication-free. IOP was significantly decreased at each postoperative visit compared with baseline (P < 0.05 for all time points). Cumulative proportions of complete and partial success were 79.2% and 95.8%, respectively, at three years postsurgery. Patients without prior antiglaucoma procedures, without postoperative IOP spikes, and those undergoing complete trabeculotomy exhibited improved surgical prognosis. No permanent vision-threatening complications occurred in the 24 eyes by the end of the respective follow-ups.
CONCLUSIONS: Gonioscopy-assisted transluminal trabeculotomy emerged as a safe and effective procedure for PCG treatment, characterized by outstanding IOP reduction efficacy and high surgical success rates.
摘要：
背景：这项回顾性研究旨在评估房角镜辅助经腔小梁切开术（GATT）在中国原发性先天性青光眼（PCG）患者中的疗效和安全性，并确定影响手术成功的因素。
方法：招募了14例诊断为PCG的患者（24只眼），这些患者接受了房角镜辅助的经腔小梁切开术，和眼内压（IOP）的数据，抗青光眼药物，手术相关并发症,在术前和术后访视期间收集其他治疗方法。手术成功率定义为IOP≤21mmHg且比基线降低>30%。有（部分成功）或没有（完全成功）抗青光眼药物。
结果：术前平均IOP为30.41±6.09mmHg。在最后一次访问中,平均眼压下降16.1±9.1mmHg（52%），24只眼中有19只眼不使用局部药物。与基线相比，每次术后随访的IOP均显着降低（所有时间点P<0.05）。完全和部分成功的累积比例分别为79.2%和95.8%，分别,手术后三年.之前没有抗青光眼手术的患者，没有术后IOP峰值，接受完全小梁切开术的患者手术预后改善.到各自的随访结束时，24只眼均未发生永久性视力威胁并发症。
结论：房角镜辅助经腔小梁切开术是一种安全有效的PCG治疗方法，具有显著的眼压降低效果和较高的手术成功率。
方法：招募了14例诊断为PCG的患者（24只眼），这些患者接受了房角镜辅助的经腔小梁切开术，和眼内压（IOP）的数据，抗青光眼药物，手术相关并发症,在术前和术后访视期间收集其他治疗方法。手术成功率定义为IOP≤21mmHg且比基线降低>30%。有（部分成功）或没有（完全成功）抗青光眼药物。
结果：术前平均IOP为30.41±6.09mmHg。在最后一次访问中,平均眼压下降16.1±9.1mmHg（52%），24只眼中有19只眼不使用局部药物。与基线相比，每次术后随访的IOP均显着降低（所有时间点P<0.05）。完全和部分成功的累积比例分别为79.2%和95.8%，分别,手术后三年.之前没有抗青光眼手术的患者，没有术后IOP峰值，接受完全小梁切开术的患者手术预后改善.到各自的随访结束时，24只眼均未发生永久性视力威胁并发症。
结论：房角镜辅助经腔小梁切开术是一种安全有效的PCG治疗方法，具有显著的眼压降低效果和较高的手术成功率。
