Twenty-four-hour intraocular pressure profiles and gonioscopic findings after gonioscopy-assisted transluminal trabeculotomy in primary open-angle glaucoma: a retrospective case series.

Background: To investigate changes in 24-h intraocular pressure (IOP) profiles and gonioscopic findings before and after gonioscopy-assisted transluminal trabeculotomy (GATT) in patients with primary open-angle glaucoma (POAG). Methods: This retrospective case series included 15 patients (25 eyes) with POAG who underwent GATT at the Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Chengdu University of Traditional Chinese Medicine, between January 2019 and January 2022 and completed pre- and postoperative 24-h IOP monitoring. Postoperative monitoring was performed at 3-6 months after surgery, after IOP-lowering medications had been discontinued for at least 7 days. Patients were followed for 2 years. Outcomes included pre- and postoperative 24-h IOP parameters, office IOP and medication burden at baseline and 2 years, and gonioscopic findings. Results: The 24-h IOP peak decreased significantly from 26.16 ± 1.44 mmHg preoperatively to 21.16 ± 0.60 mmHg postoperatively (mean ± SD; Conclusion: In this small retrospective case series of POAG eyes, GATT was associated with reductions in 24-h IOP peak and fluctuation, sustained office IOP lowering, and marked medication reduction. Gonioscopy showed stable overall angle configuration, more frequent postoperative PAS in the nasal and temporal quadrants, and postoperative changes in trabecular meshwork pigmentation grade in some quadrants. These findings should be interpreted cautiously and confirmed in larger prospective studies.