This study investigated the role of oxidative stress in primary open-angle glaucoma (POAG) by comparing serum levels of ischemia-modified albumin (IMA), malondialdehyde (MDA), and total thiol (TT) between POAG patients and healthy controls. The study included 48 POAG patients and 54 age- and sex-matched healthy controls. Serum concentrations of IMA, MDA, and TT were measured using established assay methods. Statistical analysis revealed significantly higher levels of IMA and MDA and lower levels of TT in POAG patients than controls (p < 0.001). The findings show that patients with POAG tend to have higher oxidative stress levels and a weaker antioxidant defense system. This suggests that POAG patients are exposed to increased oxidative stress and lack sufficient antioxidants to counteract it. The imbalance between oxidants and antioxidants observed in these patients may indicate that oxidative stress plays a potential role in the development of the disease. Further population-based studies are necessary to clarify the causal relationship between these markers and the development or progression of POAG.

To evaluate the baseline characteristics of patients with open-angle glaucoma (OAG) who underwent primary glaucoma surgery between 2020 and 2024, and to analyze trends in surgical preferences. Medical records of patients older than 18 years who underwent primary glaucoma surgery were reviewed retrospectively. Surgical procedures included trabeculectomy, Ahmed Glaucoma Valve (AGV) implantation, gonioscopy-assisted transluminal trabeculotomy (GATT), Kahook Dual Blade (KDB), XEN Gel Stent implantation, and diode laser cyclophotocoagulation. A total of 1,192 eyes were included, and the annual number of operated eyes was 158 in 2020, 231 in 2021, 245 in 2022, 326 in 2023, and 232 in 2024. Age, IOP, BCVA, and glaucoma stage were similar across the years (all p > 0.05), whereas the number of preoperative medications was higher in 2020 than in the following years (p < 0.01). Across all years, surgery was performed most frequently in eyes with severe glaucoma, and trabeculectomy remained the most common procedure. In 2023 and 2024, the frequencies of trabeculectomy and AGV implantation decreased, whereas GATT increased and became the third most commonly performed procedure. The minimally invasive glaucoma surgery (MIGS) group included more mild-to-moderate cases and fewer severe cases, and had better BCVA and lower IOP than the non-MIGS group (all p < 0.05). Baseline characteristics remained largely stable over the five-year period, except for higher preoperative use of antiglaucoma medications in 2020. Surgical practice shifted toward GATT and MIGS in 2023 and 2024. Compared with the non-MIGS group, the MIGS group included a higher proportion of eyes with mild-to-moderate disease, while trabeculectomy remained the most commonly performed procedure overall.

PurposeTo investigate the efficacy of lensectomy (LE) and the role of additional goniosynechialysis (LE-GSL) in eyes with medically uncontrolled synechial angle-closure glaucoma (ACG).MethodsThe records of patients who underwent LE or LE-GSL for >180° synechial ACG were reviewed retrospectively. Three groups were formed based on intraoperative gonioscopy (IOG) findings following lensectomy and intraocular lens implantation: Group 1 (n = 39), eyes with total peripheral anterior synechiae (PAS) in which GSL was performed; Group 2 (n = 37), eyes with PAS ≥ 180° and <360° in which GSL was performed; and Group 3 (n = 35), eyes with PAS < 180° in which no GSL was performed.ResultsA total of 111 eyes of 98 patients (M/F: 46/52; mean age: 60.1 ± 11.01 years) were included in the study. Median postoperative follow-up time was 12.0 months. Median PAS extents in the three groups were 12, 6, and 0 clock hours (CH) on IOG, compared to 12, 10, and 7 CH before surgery. GSL was performed in Groups 1 and 2, with a median of 11 and 4 CH. Median IOP at the final visit was 14 mmHg in all three groups. Total success rates were 87%, 81%, and 97% in Groups 1, 2, and 3, respectively (p = 0.102).ConclusionThe present study identified discrete groups of patients who would benefit from LE alone versus needing further GSL in synechial ACG. When PAS was <180° on IOG, LE alone effectively reduced IOP; in eyes with extensive PAS, performing additional GSL yielded successful results, comparable to eyes undergoing LE alone.

BACKGROUND:To examine the impact of peripapillary atrophy (PPA) on retinal nerve fibre layer (RNFL), ganglion cell-inner plexiform layer (GCL-IPL), and Bruch's membrane opening-minimum rim width (BMO-MRW) in non-glaucomatous myopic eyes. METHODS:Patients with myopic refractive errors greater than -4.00 dioptres and with normal intraocular pressure (10-21 mmHg) were included in the study. Eyes without PPA were included in group 1, and those with PPA in group 2. RNFL (3.5, 4.1, 4.7 mm) and BMO-MRW were measured with Spectralis OCT (Heidelberg Engineering, Heidelberg, Germany); GCL-IPL with Cirrus HD-OCT 5000 (Carl Zeiss Meditec, Dublin, CA, USA). RESULTS:There were 50 eyes in group 1 and 77 eyes in group 2. Mean age, refractive error, axial length, disc area, rim area, cup-to-disc ratio, mean RNFL and GCL-IPL (mean and minimum) were similar in both groups (p > 0.05 for all). Mean nasal RNFL thickness measured with Cirrus HD-OCT and mean nasal RNFL thicknesses at 3.5 mm and 4.1 mm measured with Spectralis OCT were significantly lower in group 2 (p < 0.05 for all). Nasal RNFL thickness at 4.7 mm and RNFL thicknesses in the other regions at different diameters (3.5 mm, 4.1 mm and 4.7 mm) and BMO-MRW in all regions were similar in both groups (p > 0.05 for all). DISCUSSION:RNFL thickness at 4.7 mm, BMO-MRW, and GCL-IPL did not significantly differ with PPA. These stable measurements may assist in diagnosing and monitoring glaucoma in myopic eyes with PPA.

Background and Objectives: Keratoconus (KC) is a progressive corneal ectatic disorder characterized by stromal thinning, irregular astigmatism, and visual impairment. Increasing evidence suggests that oxidative stress plays a significant role in the pathogenesis of KC. Biomarkers such as ischemia-modified albumin (IMA), malondialdehyde (MDA) and total thiol (TT) have been widely used to assess oxidative status. This study aims to evaluate the role of oxidative stress in KC disease by comparing serum levels of IMA, MDA, and TT between KC patients and healthy controls. Material and Methods: Forty patients diagnosed with KC and 43 healthy individuals of similar age and gender were included in the study. Patients with KC were classified in 4 stages according to the modified Krumeich KC classification system. IMA, MDA, and TT levels were compared in serum samples from patient and control groups. Results: Serum IMA levels were 2.52 ± 0.07 in the KC group and 1.2 ± 0.03 in the control group. The difference was statistically significant (p < 0.001). While serum MDA levels were 1.68 ± 0.05 in the KC group, they were 0.74 ± 0.04 in the control group. The difference was statistically significant (p < 0.001). Serum TT levels were 0.82 ± 0.41 in the KC group and 2.23 ± 0.04 in the control group. The difference was statistically significant (p < 0.001). Conclusions: Elevated serum IMA and MDA levels, together with decreased TT levels, in patients with KC are likely associated with increased oxidative stress. These parameters may serve as auxiliary biomarkers for evaluating disease pathophysiology and may represent potential targets for future diagnostic and therapeutic strategies.

Objectives:This study compares the long-term outcomes and success rates of trabeculectomy and Ahmed glaucoma valve (AGV) implantation in vitrectomized eyes. Methods:This study included 58 eyes of 58 patients who had undergone pars plana vitrectomy and subsequently received either trabeculectomy (25 eyes) or AGV implantation (33 eyes) at our hospital between March 01, 2017 and April 01, 2023 and had at least 1-year follow-up. Complete success was defined as maintaining an intraocular pressure (IOP) between 5 and 21 mmHg without medication, whereas overall success was defined as achieving the same IOP range with or without medication. Failure was defined as an IOP exceeding 21 mmHg or falling below 5 mmHg, visual deterioration to light perception due to glaucoma progression or complications from glaucoma surgery, or the need for further glaucoma surgery. Results:The complete success was higher in the trabeculectomy group. Whereas both groups' overall success rates were similar at the last follow-up (p=0.04). Both groups demonstrated a comparable failure rate (p=0.44). The probability of success in the trabeculectomy group was 92.0% at 12 months, 88.0% at 24 months, and 84.0% at 36 months, whereas in the AGV group, it was 87.8% at 12 months, 81.8% at 24 months, and 75.7% at 36 months. There was no difference in terms of post-operative complication rate in both groups. (p=0.36). Conclusion:Both AGV implantation and trabeculectomy yield comparable outcomes in vitrectomized eyes. However, trabeculectomy reduced the requirement for antiglaucoma medications postoperatively. Consequently, trabeculectomy may be a viable option in carefully selected vitrectomized eyes.

Purpose To evaluate the alterations in the Schlemm's canal (SC) and trabecular meshwork (TM) morphology after phacoemulsification surgery in pseudoexfoliative glaucoma (PEXG) patients with swept-source optical coherence tomography (OCT). Methods In this retrospective comparative study, patients with PEXG and visually healthy individuals with cataract who underwent phacoemulsification and intraocular lens implantation surgery were included. Anterior segment OCT measurements and intraocular pressures (IOPs) were recorded at the first visit before surgery and at postoperative 1-month visits. Manual measurements obtained from OCT were as follows: SC-diameters; anteroposterior and radial SC diameter (SC-APD, SC-RD); cross-sectional area of SC (SC-CSA); and TM height (TM-H) and cross-sectional area of TM (TM-CSA). Results Sixty-three eyes of 63 subjects were included in the study, with 43 patients having PEXG and 20 patients serving as controls. There was a significant decrease in IOP after surgery in the PEXG eyes ( p < 0.001). Preoperatively, SC-diameters were significantly lower in PEXG eyes than in the control group ( p < 0.001). After surgery, SC-diameters had increased significantly in PEXG eyes ( p < 0.001). At the preoperative visit, TM-CSA and TM-H were higher in PEXG eyes than in the control group, but only TM-H showed a statistically significant difference ( p = 0. 199 and p = 0.015, respectively). There was a significant reduction in TM-CSA and TM-H in PEXG eyes after surgery ( p < 0.001 and p = 0.024, respectively). Conclusion The study showed that both SC dimensions and area increased and TM-H and TM-CSA decreased after phacoemulsification surgery in PEXG eyes. There was a significant correlation between these changes and postoperative IOP in PEXG eyes.

To compare Bruch’s Membrane Opening- Minimum Rim Width (BMO-MRW), peripapillary retinal nerve fibre layer (pRNFL) thickness at different peripapillary diameters, and ganglion cell layer- inner plexiform layer (GCL-IPL) thickness between in eyes with small optic discs and normal discs. In this cross-sectional study, we selected healthy eyes. The patients were divided into two groups: the first group consisted of those with a disc area smaller than 1.60 mm² (Small disc group, 92 patients), and the second group included those with a disc area between 1.60 mm² and 2.50 mm² (Normal disc group, 71 patients). Spectralis OCT (Heidelberg Engineering, Inc., Heidelberg, Germany) was used to measure BMO-MRW and pRNFL thickness at three different diameters (3.5 mm, 4.1 mm, and 4.7 mm) using the Glaucoma Module Premium Edition (GMPE) software version 6.0. The thickness of GCL-IPL and pRNFL at a diameter of 3.4 mm were measured using Cirrus OCT (Carl Zeiss Meditec, Dublin, CA, USA). In the small disc group, the disc area, rim area, and cup/disc ratio were smaller compared to the normal disc group (p < 0.05 for each). In the small disc and normal disc groups, pRNFL thickness at each three diameters (3.5 mm, 4.1 mm, and 4.7 mm) measured by Spectralis OCT were similar in all quadrants (superior temporal, superior nasal, nasal, inferonasal, inferotemporal, and temporal) and GCL-IPL (average, minimum) and pRNFL thickness measured with Cirrus OCT were similar in all quadrants (superior, nasal, inferior, and temporal). However, BMO-MRW measurements in all quadrants were larger in the small disc group (p < 0.05 for all). RNFL and GCL-IPL measurements were similar in all quadrants in both group. However, BMO-MRW measurements were higher in all quadrants in the small disc groups.

Objectives: This retrospective study aimed to evaluate the one-year surgical success of gonioscopy-assisted transluminal trabeculotomy (GATT) and identify prognostic factors influencing surgical outcomes in eyes diagnosed with open-angle glaucoma. Materials and Methods: A total of 225 eyes (214 patients) treated with GATT between March 1, 2018, and June 1, 2024, were included in the study. Preoperative and postoperative data were analyzed. Complete surgical success (Criterion A) was defined as having an intraocular pressure (IOP) between 5 and 18 mmHg or at least a 30% reduction in IOP without the need for additional surgery. Overall success referred to achieving the same IOP with or without glaucoma medications. Surgical failure was defined as IOP >18 mmHg or <5 mmHg, significant vision loss, or the need for additional surgical intervention. Results: The mean age of patients was 64.4±11.9 years, and the mean axial length (AL) was 24.0±2.0 mm. The mean preoperative IOP was 26.7±7.3 mmHg, which decreased to 14.3±6.5 mmHg at 12 months postoperatively (p<0.05). The rate of complete success according to Criterion A was 41.3%, while the rate of overall success was 87.6%. Multivariate analysis revealed that higher preoperative IOP (odds ratio [OR]: 1.07; p=0.02), longer AL (OR: 1.3; p<0.01), and postoperative IOP spikes (OR: 5.18; p<0.01) were significantly associated with surgical failure. Patients who underwent circumferential (360°) GATT had significantly higher success rates compared to those who received hemi-GATT (OR: 4.69; p=0.01). Glaucoma stage, presence of pseudoexfoliation glaucoma, history of prior trabeculectomy, and vitrectomy were not significantly associated with surgical outcomes (p>0.05 for all). Conclusion: GATT is an effective and safe surgical option for various types of glaucoma. Higher preoperative IOP, longer AL, and postoperative IOP spikes increase the risk of surgical failure, whereas circumferential GATT is associated with improved success rates. GATT can also be considered as a potential alternative for patients with prior glaucoma surgery or advanced-stage glaucoma.

This study aims to compare one-year results and success rates of trabeculectomy and gonioscopy-assisted transluminal trabeculotomy (GATT) in eyes with long axial length (AL) and glaucoma. This retrospective study included patients with an AL greater than 24 mm who underwent trabeculectomy (29 eyes) or GATT surgery (33 eyes) in our hospital and had at least a one-year follow-up. Complete success was defined as achieving an IOP > 5 and ≤ 21 mmHg (criterion A), > 5 and ≤ 18 mmHg (criterion B), or > 5 and ≤ 15 mmHg (criterion C), without the use of antiglaucoma medications or additional surgical interventions, except for bleb needling. The same IOP levels with or without medication were considered as overall success. The GATT group required significantly more antiglaucoma medications at the 1-week, 1-month, and 3-month follow-ups (p < 0.05 for all). Complete success rates were higher in the trabeculectomy group based on criteria A, B, and C (p < 0.05 for each), and the overall success rates based on criteria A, B, and C were similar in both groups in one-year follow-up (p > 0.05 for each). The failure rates based on all three criteria were similar in both groups (p > 0.05 for each). The cumulative probability of overall success based on criterion B was 93.1, 86.2 and 79.3

Abstract:PURPOSE: To examine the change in corneal endothelial cell density (ECD) after gonioscopy-assisted transluminal trabeculotomy (GATT) surgery alone or in combination with phacoemulsification (phaco). Abstract:METHODS: In this prospective monocentric comparative study, consecutive patients were enrolled with open angle glaucoma (OAG) and who had been treated with GATT or phaco + GATT, with complete endothelial cell data and at least 6 months of follow-up. Patients who underwent phaco surgery alone during the same period were recorded as the control group. The main outcomes were ECD changes. Abstract:RESULTS: The study included 64 OAG (40 eyes in the GATT and 24 eyes in the GATT + phaco groups) and 30 control eyes (phaco group). There was a significant decrease in mean ECD compared to baseline in the GATT, phaco + GATT, and phaco groups (p < 0.001 for all). At the end of follow-up, percent cumulative ECD reduction values were 6.89%, 14.47% and 10.32% in the GATT, phaco + GATT, and phaco groups, respectively (p = 0.01 for all groups). The ECD reduction in the phaco + GATT group (p = 0.02) and in the phaco group (p = 0.04) was significantly higher than in the GATT group. ECD reduction was similar in the phaco + GATT and phaco groups (p = 0.69). Abstract:CONCLUSIONS: A significant ECD loss was observed in 6 months period after GATT surgery compared to the baseline. The ECD reduction observed after GATT combined with phacoemulsification was greater than with GATT alone. There was no significant difference between phaco-GATT combined surgery and phaco alone.

Clinical relevanceVisual field testing is essential in the diagnosis and management of various ophthalmic diseases, particularly glaucoma. Integrating ChatGPT-4 into the interpretation of these tests has the potential to aid clinical decision making and improve efficiency and accessibility in clinical practice.BackgroundThis study aims to evaluate the capability of ChatGPT-4 in interpreting visual field tests.MethodA total of 30 patient visual field printouts, either with or without defects, were included in this study. The performance of ChatGPT-4 in identifying test name, pattern, reliability indices, total deviation map, pattern deviation map and greyscale map was evaluated and compared with that of 2 experienced glaucoma consultants. The study also focused on the ability of ChatGPT to categorise tests as 'normal' or suggest diagnosis by interpreting tests accurately.ResultsThe results showed that ChatGPT-4 was highly accurate in identifying test names (100%), patterns (90%) and global visual field indices (96.7%). It also accurately classified tests as reliable or unreliable (93.3%).The model provided 66.7% and 30% accurate and adequate answers in interpreting deviation and greyscale maps, respectively. In addition, in 33.3% of tests, it was able to accurately interpret the visual field test and classify it as 'normal' or suggest a diagnosis.ConclusionThe study highlights the potential of large language models like ChatGPT-4 in assessing visual field tests. ChatGPT-4 could interpret numeric data on tests accurately. However, it was inadequate in interpreting deviation and greyscale maps and suggesting a diagnosis according to the defects.

To evaluate the frequency, timing, and characteristics of intraocular pressure (IOP) spikes following standalone Gonioscopy-Assisted Transluminal Trabeculotomy (GATT), and to assess their predictors and management strategies. A retrospective observational study. A total of 210 eyes that underwent 360° GATT between September 2021 and January 2024 at our tertiary eye hospital were included. Demographics, best-corrected visual-acuity (BCVA), IOP, antiglaucoma medications, complications and interventions were recorded. IOP spikes were defined as >30 mmHg or >10 mmHg above baseline within two months postoperatively and classified as hyperacute (0–3 days), acute (4–9 days), or subacute (10–60 days). Surgical success was defined as IOP: 5–21 mmHg with ≥20

Objectives:To evaluate the refractive outcomes, changes in intraocular pressure (IOP) and anterior chamber depth (ACD), and postoperative complications following lensectomy for angle-closure in cases of simple extreme microphthalmos. Materials and Methods:This retrospective study analyzed eyes with simple extreme microphthalmos (axial length <18 mm) that underwent lensectomy between January 2015 and July 2024. Data collection included demographic details, preoperative and postoperative best corrected visual acuity (BCVA), IOP, number of antiglaucoma medications, ACD, the diopter (D) of the implanted intraocular lens (IOL) according to the Hoffer-Q formula, postoperative refractive error, and surgical complications. Results:A total of 20 eyes from 12 patients were analyzed, with a mean patient age of 55.4±8.7 years and an average axial length of 16.48±0.8 mm. The average power of the implanted IOL was 53.32±6.2 D, ranging from 44 to 64 D. The mean preoperative spherical refractive equivalent (SE) was +12.4±2.8 D, while the mean postoperative SE was -6.67±5.2 D (p<0.05). Postoperative spherical refractive error exceeding -1.00 D was detected in 15 eyes (75%). Postoperatively, significant decreases were observed in IOP and the need for antiglaucoma medication (p=0.02 for both). The mean ACD increased significantly after surgery compared to the preoperative ACD (p=0.01). The difference between the intended refractive outcome and the postoperative spherical refractive error was statistically significant (p<0.05). Postoperatively, 8 eyes (40%) had a BCVA of ≤0.7 logarithm of the minimum angle of resolution (logMAR), 10 (50%) had a BCVA between >0.7 and <1.4 logMAR and 2 eyes (10%) had a BCVA of ≥1.4 logMAR. Conclusion:Lensectomy in cases of extreme microphthalmos effectively reduces IOP and reliance on antiglaucoma medications and increases the ACD. However, a notable incidence of postoperative myopic refractive error remains a concern.

PURPOSE:To evaluate the changes in thickness of tissues, specifically the pericardium patch graft (PPG) covering the silicone tube in Ahmed Glaucoma Valve (AGV) surgery.STUDY DESIGN:Prospective observational study.METHODS:This study included cases with refractory glaucoma that underwent AGV implantation with PPG coverage. Conjunctival epithelium, stroma and PPG thickness covering the tube were measured using anterior segment optical coherence tomography (AS-OCT) at 1, 6 and 12 months. Additionally, the same measurements were taken 1500 µm away from the tube as a control for the central measurements.RESULTS:Twenty-seven eyes of 27 patients were evaluated in the study. Although PPG thickness decreased significantly in both regions, the amount of reduction was more pronounced centrally. Centrally, the reduction rate was 21.2% and 34.8% during the 1-6 months period and 6-12 months period, while peripherally it was 3.5% and 5.1%, respectively. No change was observed in the thickness of the epithelium during the follow-up period. There was a significant thinning of the stroma in the central and peripheral regions during the 1-6 months period (30.5% and 17%, respectively). No cases of exposure were observed during the follow-up period.CONCLUSION:Although the most evident thinning of the layers covering the tube was observed in the early postoperative period, PPG showed a stable decrease even in the late period. The progressive reduction in the PPG thickness observed also in the peripheral region indicates that factors beyond mechanical forces contribute to this degenerative process. AS-OCT could be a valuable non-invasive tool in clarifying this process.

CLINICAL RELEVANCE:Determining how Schlemm's canal is affected by trabeculectomy may become a marker for evaluating and monitoring surgical success. BACKGROUND:This study aims to evaluate the morphological changes in Schlemm's canal after trabeculectomy using anterior segment optical coherence tomography (AS-OCT). METHODS:Thirty-five eyes of 35 patients who were followed up for open-angle glaucoma and indicated for trabeculectomy were included in the study. AS-OCT was performed preoperatively and at week 1, month 1 and month 3 postoperatively. The coronal and meridional diameters of Schlemm's canal were measured in the temporal and nasal quadrants via AS-OCT. RESULTS:The meridional diameter length of Schlemm's canal was higher in the nasal quadrant than in the temporal quadrant. Nasally, the mean preoperative meridional diameter length was 326.8 ± 88.5 μm, which increased at postoperative week 1 and month 1. Temporally, it was 271.5 ± 91.5 μm and showed a non-significant change postoperatively. The mean preoperative coronal diameter length was 10.9 ± 6.5 μm and 11.9 ± 6.0 μm in the nasal and temporal quadrants, respectively. A statistically significant increase was found in the measurements of the nasal quadrant at week 1 (p = 0.005) and month 1 (p = 0.049), and in the temporal quadrant at week 1 (p = 0.023). CONCLUSION:A significant enlargement of the canal occurs at the first postoperative week, followed by a gradual reduction thereafter. The increase in size is mostly observed in the coronal diameters, resulting in the expansion of the canal.

PURPOSE:To compare the intraocular pressure (IOP)-lowering efficiency of gonioscopy-assisted transluminal trabeculotomy (GATT) and trabeculectomy (TRAB) with mitomycin C in patients with primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (PEXG). METHODS:In this retrospective comparative study, consecutive patients with POAG or PEXG who underwent GATT or TRAB by a single surgeon and with a follow-up period of at least 1 year were included. Surgical success rates, change in best-corrected visual acuity, IOP, the need for antiglaucoma medication, surgical complications, and the need for additional glaucoma surgery were compared. Surgical success was defined as an IOP reduction of ≥30% or an IOP of ≤18 mmHg. Complete success was defined as without medication. Qualified success was defined as with or without topical medication. RESULTS:The mean baseline IOP was 27.4 ± 8.3 and 24.6 ± 7.6 mmHg ( P = 0.13) with the mean number of medications being 3.7 ± 1.0 and 3.7 ± 1.1 ( P = 0.98) in TRAB and GATT, respectively. At 12 months, the mean IOP was 15.3 ± 3.5 and 12.5 ± 4.6 mmHg ( P = 0.24) with the mean number of medications being 0.9 ± 1.2 and 0.8 ± 1.4 ( P = 0.76) after GATT and TRAB, respectively. IOP was lowered from baseline by 52.7% ± 17.5% after TRAB and 45.7% ±18.6% after GATT ( P = 0.12). There was no decrease in best-corrected visual acuity in either group. The qualified surgical success rate was 94.4% in the GATT group and 94.9% in the TRAB group ( P = 0.75). Percentage of complete success was 64.1% and 52.8% ( P = 0.22) after TRAB and GATT, respectively. CONCLUSION:In patients with POAG and PEXG, GATT was as effective and safe as TRAB in lowering IOP and reducing the number of antiglaucomatous drugs.