Incidence of Descemet Membrane Detachment post Gonioscopy-Assisted Transluminal Trabeculotomy in patients with Open Angle Glaucoma

Background To determine the incidence of Descemet membrane detachment (DMD) following gonioscopy-assisted transluminal trabeculotomy (GATT) using anterior segment optical coherence tomography (AS-OCT) in patients with open-angle glaucoma. Methods This prospective clinical study included 30 eyes treated with GATT between June 2022 and January 2023. All patients were examined with spectral-domain AS-OCT (Optovue RTVue; Optovue Inc., Fremont, CA, USA) on the first postoperative day to assess for DMD. In cases where DMD was detected, AS-OCT imaging was repeated after one week to evaluate for spontaneous resolution. Results DMD occurred in 1 of the 30 eyes (3.3%), indicating a low incidence following GATT. Significant reductions were observed between pre- and postoperative intraocular pressure (IOP) and the number of glaucoma medications. Postoperative hyphema occurred in 20% of cases and resolved spontaneously within one week. Complete surgical success was achieved in 60% of eyes, while qualified success was noted in 30%, and 10% were classified as failures. IOP spikes were recorded in 3 eyes (10%). Conclusion The incidence of Descemet membrane detachment following GATT was low, supporting the procedure as a safe surgical option for patients with open-angle glaucoma. Trial Registration The study was approved by the Ethics Committee of Kasr AlAiny Medical School, Cairo University, and registered at ClinicalTrials.gov (NCT05932940) on 7th of May 2023