GATT glaucoma surgery

Glaucoma is an eye disease that damages the optic nerve and can lead to vision loss. It is often caused by elevated intraocular pressure, which results from impaired fluid drainage from the eye. GATT, or Gonioscopy Assisted Transluminal Trabeculotomy, is a surgical procedure designed to treat open angle glaucoma. Unlike other glaucoma surgeries that create a new bypass for the drainage system, GATT works by mechanically opening the eye's natural drainage system, thereby restoring proper fluid flow and reducing intraocular pressure.

GATT surgery is primarily suitable for patients with open angle glaucoma, where the eye's drainage canals are blocked but the angle structure itself is open. The decision for surgery depends on factors such as the severity of glaucoma, the desired target intraocular pressure, and the overall condition of the eye. Sometimes, GATT surgery can be combined with cataract surgery, allowing for simultaneous treatment of both conditions.

The surgery is typically performed under local anesthesia. The surgeon makes a small incision, usually less than two millimeters, in the front part of the eye. Using a special lens placed on the eye, the drainage canal is located, and an opening is created within it. A thin catheter is then threaded through this opening, and its manipulation causes the drainage system to open along its circumference. This action allows for improved fluid drainage from the eye, without the need for implanting a device or extensive cutting of tissues around the eye. At the end of the procedure, the incision is closed without sutures.

Before surgery, it is important to consult with your doctor regarding regular medications, especially blood thinners, which may need to be temporarily stopped to reduce the risk of bleeding. The surgery itself usually takes less than an hour. Most patients are discharged home on the same day, after the eye is covered with a patch and a plastic shield overnight.

The day after surgery, the patch and shield are removed, and vision and intraocular pressure are checked. The patient will receive instructions for using antibiotic and steroid eye drops to prevent infection and promote healing. It is important to continue using existing glaucoma drops as directed by the doctor. In the first few weeks after surgery, avoid strenuous physical activity, lifting heavy objects, swimming, bending over, eye makeup, and rubbing the eye. It is recommended to wear sunglasses outdoors and use an eye shield during sleep for one to two weeks.

After surgery, the eye may be red, and there might be stinging, burning, tearing, and mild pain, which usually resolve within a few days. Vision may be blurry for several weeks. The most common side effect is temporary bleeding in the front of the eye (hyphema), which usually clears on its own within days to weeks. Pressure spikes can also occur during recovery and need monitoring. Other possible complications include abnormally low eye pressure or infection. In rare cases, these complications can lead to vision loss.

Post operative follow up includes frequent visits to the ophthalmologist to check intraocular pressure and the condition of the eye. The goal of the surgery is to reduce intraocular pressure and minimize the progression of glaucoma damage, not to restore lost vision. For most patients, intraocular pressure significantly decreases, and many can reduce or discontinue their glaucoma medications. You should contact the medical team in case of significant pain, severe eye discharge, fever above 38 degrees Celsius, or vision loss.