Efficacy and safety of gonioscopy-assisted transluminal trabeculotomy in vietnamese patients with moderate to advanced primary open-angle glaucoma

Abstract: PURPOSE: Gonioscopy-assisted transluminal trabeculotomy (GATT) is a minimally invasive, conjunctiva-sparing procedure increasingly used in glaucoma surgery. This study evaluates the efficacy and safety of GATT in Vietnamese patients with moderate to advanced primary open-angle glaucoma (POAG). MATERIALS AND METHODS: This retrospective case series included 41 eyes with moderate to advanced POAG treated with GATT at Ho Chi Minh Eye Hospital between January 2024 and May 2025. The primary outcome was surgical success, defined as intraocular pressure (IOP) ≤18 mmHg or ≥30% reduction without further surgery. Complete success indicated medication-free control; qualified success included eyes requiring medications. Patients were followed for 12 months. RESULTS: Mean baseline IOP was 28.17 ± 9.12 mmHg on 3.7 ± 0.46 medications. At 12 months, mean IOP decreased to 13.83 ± 2.21 mmHg ( P < 0.001), and medication use dropped to 1.61 ± 1.12 ( P < 0.001). Complete success was achieved in 22.0% of eyes, and qualified success in 73.1%. Visual acuity remained stable. Hyphema occurred in 54.8% of cases, resolving spontaneously. No serious complications or reoperations were reported. CONCLUSION: GATT is a safe and effective surgical option for moderate to advanced POAG, offering significant IOP reduction and decreased medication use with minimal complications.