Gonioscopy-Assisted Transluminal Trabeculotomy versus Bent Ab Interno Needle Goniectomy in Patients with Open-Angle Glaucoma

Abstract

Objectives: To compare the efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) and bent ab interno needle goniectomy (BANG) in patients with open-angle glaucoma (OAG). Materials and Methods: This retrospective comparative study included 65 eyes diagnosed with OAG that underwent GATT (34 eyes) or BANG (31 eyes). Intraocular pressure (IOP) was measured using Goldmann applanation tonometry at baseline and during follow-up visits. Success was categorized as qualified (IOP ≤21 mmHg with ≥20% reduction) and complete (same criteria without medication). Complications and the need for further surgery were recorded. Results: Preoperative mean IOP was 32.9±6.1 mmHg for GATT and 31.8±5.4 mmHg for BANG. At the final visit, mean IOP was reduced to 15.8±4.5 mmHg in the GATT group (51.9% reduction) and 17.9±5.7 mmHg in the BANG group (43.7% reduction). The complete success rate was 88.2% for GATT and 61.3% for BANG. Early failures were more frequent in BANG, while GATT showed fewer but later failures. Both procedures had minimal complications, with transient hyphema being the most common. Conclusion: In this study, GATT provided greater and more sustained IOP reduction and higher long-term success rates compared to BANG, making it a more reliable option for managing OAG.