Systematic review and Meta-analysis of treating open angle glaucoma with gonioscopy-assisted transluminal trabeculotomy

Abstract

AIM: To systematically review and Meta-analyze studies of managing open angle glaucoma (OAG) with gonioscopy-assisted transluminal trabeculotomy (GATT) and to evaluate its effectiveness and safety. METHODS: Eligible studies were retrieved and screened from five main electronic databases. Mean difference (MD) was hired to show the pooled effectiveness of intraocular pressure (IOP) and medication decrease achieved by GATT. In addition, combined surgical success and reoperation rates were calculated, and complications were also summarized. RESULTS: Ten studies were included for systematic review, but one study was not pooled for Meta-analysis due to the repeated data. The combined IOP decrease after GATT was 9.81 mm Hg (95%CI: 7.98-11.63 mm Hg) which showed significant reduction from the baselines (Z=10.52, P<0.0001). Similarly, the number of medications after GATT also decreased distinctly compared with that of medication before the surgery (Z=9.09, P<0.0001), and the pooled medication decrease was 1.68 (95%CI: 1.31-2.04). In addition, the combined surgical success rate was 85%, while the pooled reoperation rate was 20%. Sight-threatening complications occurred scarcely, whereas the pooled occurrence rate of hyphemia was as high as 36.0%. CONCLUSION: GATT could effectively lower IOP and decrease medications for patients with OAG. Moreover, the procedure appears to be a safe and promising treatment for OAG due to its minimally-invasive and conjunctiva-sparing nature.