DONATE NOWGonioscopy-Assisted Transluminal Trabeculotomy
The Glaucoma Associates of Texas in Dallas, TX developed the GATT procedure. Since its inception, the doctors at Glaucoma Associates have performed thousands of this surgery successfully, more than all surgeons combined world-wide. The doctors have spoken extensively about GATT, nationally and internationally, and other doctors from around the world have come to Dallas, TX to observe and learn how to perform GATT by the doctors at Glaucoma Associates of Texas.
What is GATT?
GATT (Gonioscopy-Assisted Transluminal Trabeculotomy) is a minimally invasive surgical treatment for the management of open angle glaucomas and is a modification of a glaucoma surgery (trabeculotomy) that has been around for over 50 years. Trabeculotomy has a proven history of being safe and effective for the treatment of open angle glaucoma.
How do surgeons perform GATT?
Surgeons perform the GATT procedure through micro-incisions in the cornea. They make a 1.0 mm incision at the cornea’s periphery to complete the surgery. After entering the eye, the surgical procedure involves cutting through the trabecular meshwork, cannulating Schlemm’s canal 360°, and unroofing Schlemm’s canal.
One major advantage of this procedure is that it is able to access the entire natural drainage system and open in 360°, rather than targeting only a small portion of the drainage system. Surgeons believe that opening the entire drainage system gives the best chance for the procedure to succeed and adequately lower intraocular pressure.
A second advantage of this procedure is that it does not involve opening up the conjunctival tissues to access Schlemm’s canal. Therefore, further surgery encounters less scar tissue, and subsequent procedures achieve a significantly higher success rate.
Who is a Good Candidate for GATT?
Doctors use GATT to surgically treat open-angle glaucoma in both adults and children. However, in contrast to other “angle surgeries”, some forms of closed-angle glaucoma may also benefit.
How does it work?
GATT reduces IOP by restoring the trabeculo-canalicular outflow pathway. It increases the flow of aqueous humor from the anterior chamber, directly into and around Schlemm’s canal, and out through the collector channels. This procedure routes fluid through normal physiological pathways and does not create a bleb on the eye’s surface.
For more details, please read the GATT article in Ophthalmology times.
What Steps Does the GATT Procedure Involve?
When you and your doctor decide to proceed with GATT, our preoperative scheduling nurse will provide detailed instructions on preparing for surgery and arriving at the operating room. See Preoperative instructions for more information.
This is an outpatient procedure performed in an ambulatory surgery center. The surgery itself takes less than one hour in most cases. The surgery is usually done under local anesthesia with intravenous sedation. Sometimes, this surgery is combined with other surgeries, often with cataract surgery.
After surgery, the eye generally is covered by an eye patch and protected by a plastic shield overnight. On the morning following the surgery, it is removed and the eye is examined by your ophthalmologist. Eye drops are then prescribed to prevent infection, and reduce inflammation. For more details, please see postoperative instructions.
For several weeks following the surgery, your ophthalmologist will observe your eye closely and examine you frequently. It may take up to 12 weeks after your surgery for the healing to be complete. During this time it is not unusual for your intraocular pressure, as well as vision to fluctuate. You will be ready to change your glasses prescription at around 6-8 weeks after surgery.
Please contact the Glaucoma Associates of Texas if you have questions about this treatment for glaucoma.