Tips and Tricks for Performing a Successful Gonioscopy-assisted Transluminal Trabeculotomy for Beginner Ophthalmic Surgeons

Gonioscopy-assisted transluminal trabeculotomy (GATT) is a minimally invasive glaucoma surgery (MIGS) technique that enhances aqueous outflow by disrupting the trabecular meshwork and inner wall of Schlemm’s canal. Initially described for congenital glaucoma, it has gained popularity as an effective...

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Main Author: Mahesh Bharathi
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-04-01
Series:TNOA Journal of Ophthalmic Science and Research
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Online Access:https://journals.lww.com/10.4103/tjosr.tjosr_52_25
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author Mahesh Bharathi
author_facet Mahesh Bharathi
author_sort Mahesh Bharathi
collection DOAJ
description Gonioscopy-assisted transluminal trabeculotomy (GATT) is a minimally invasive glaucoma surgery (MIGS) technique that enhances aqueous outflow by disrupting the trabecular meshwork and inner wall of Schlemm’s canal. Initially described for congenital glaucoma, it has gained popularity as an effective option for primary and secondary open-angle glaucoma. This article provides a comprehensive guide for beginner ophthalmic surgeons to optimize surgical efficiency, minimise complications, and improve outcomes in GATT. Key considerations include patient selection, pre-operative assessment, and intra-operative techniques such as angle visualization, controlled Schlemm’s canal cannulation, and trabecular meshwork incision. Strategies for managing intra-operative challenges like hyphaema and canal obstruction are also discussed. Post-operative care focusses on intraocular pressure monitoring, inflammation control, and long-term success factors. With proper training and adherence to the best practices, GATT offers a safe and effective method for reducing intra-ocular pressure while preserving future surgical options.
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publishDate 2025-04-01
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spelling doaj-art-3299aea0c4d3486caa8dd046a3082d692025-08-20T03:40:50ZengWolters Kluwer Medknow PublicationsTNOA Journal of Ophthalmic Science and Research2589-45282589-45362025-04-0163213513710.4103/tjosr.tjosr_52_25Tips and Tricks for Performing a Successful Gonioscopy-assisted Transluminal Trabeculotomy for Beginner Ophthalmic SurgeonsMahesh BharathiGonioscopy-assisted transluminal trabeculotomy (GATT) is a minimally invasive glaucoma surgery (MIGS) technique that enhances aqueous outflow by disrupting the trabecular meshwork and inner wall of Schlemm’s canal. Initially described for congenital glaucoma, it has gained popularity as an effective option for primary and secondary open-angle glaucoma. This article provides a comprehensive guide for beginner ophthalmic surgeons to optimize surgical efficiency, minimise complications, and improve outcomes in GATT. Key considerations include patient selection, pre-operative assessment, and intra-operative techniques such as angle visualization, controlled Schlemm’s canal cannulation, and trabecular meshwork incision. Strategies for managing intra-operative challenges like hyphaema and canal obstruction are also discussed. Post-operative care focusses on intraocular pressure monitoring, inflammation control, and long-term success factors. With proper training and adherence to the best practices, GATT offers a safe and effective method for reducing intra-ocular pressure while preserving future surgical options.https://journals.lww.com/10.4103/tjosr.tjosr_52_25gattglaucomamigs
spellingShingle Mahesh Bharathi
Tips and Tricks for Performing a Successful Gonioscopy-assisted Transluminal Trabeculotomy for Beginner Ophthalmic Surgeons
TNOA Journal of Ophthalmic Science and Research
gatt
glaucoma
migs
title Tips and Tricks for Performing a Successful Gonioscopy-assisted Transluminal Trabeculotomy for Beginner Ophthalmic Surgeons
title_full Tips and Tricks for Performing a Successful Gonioscopy-assisted Transluminal Trabeculotomy for Beginner Ophthalmic Surgeons
title_fullStr Tips and Tricks for Performing a Successful Gonioscopy-assisted Transluminal Trabeculotomy for Beginner Ophthalmic Surgeons
title_full_unstemmed Tips and Tricks for Performing a Successful Gonioscopy-assisted Transluminal Trabeculotomy for Beginner Ophthalmic Surgeons
title_short Tips and Tricks for Performing a Successful Gonioscopy-assisted Transluminal Trabeculotomy for Beginner Ophthalmic Surgeons
title_sort tips and tricks for performing a successful gonioscopy assisted transluminal trabeculotomy for beginner ophthalmic surgeons
topic gatt
glaucoma
migs
url https://journals.lww.com/10.4103/tjosr.tjosr_52_25
work_keys_str_mv AT maheshbharathi tipsandtricksforperformingasuccessfulgonioscopyassistedtransluminaltrabeculotomyforbeginnerophthalmicsurgeons