03/02/2026
🎞️ Video of the month | January 2026 | Gonioscopy-Assisted Transluminal Trabeculotomy (GATT) in a Pseudophakic Eye with Uncontrolled Pseudoexfoliative Glaucoma – a Minimally Invasive Approach
Presented by: Siempis Thomas MD
Edited by: Penelope Burle de Politis MD
The GATT technique was first described in 2014 by Grover’s group, in Dallas, Texas (USA), and has since been applied in various centers worldwide with excellent outcomes in both primary and secondary glaucomas. Clinical studies have shown that the GATT technique is effective not only in primary open-angle and closed-angle glaucoma, but also in pseudoexfoliative, pigmentary, uveitic, and juvenile glaucoma.
The major advantage of this technique is its conjunctiva-sparing intraocular approach. This translates into a shorter and less traumatic operation, while not affecting the effectiveness of a future bleb-based antiglaucoma surgery – i.e., traditional trabeculectomy – which may eventually be needed. This therefore allows for a gradual therapeutic strategy. The GATT technique can be combined with cataract surgery or performed as an independent procedure, which is particularly attractive as an option for secondary glaucomas, especially in younger individuals, in whom a more invasive glaucoma operation may not be the ideal first-line modality.
In this video, recorded at the Ophthalmica Eye Institute in Thessaloniki, Greece, Dr. Thomas Siempis (MD, FRCOphth, FEBO), consultant in glaucoma, cataract and advanced anterior segment surgery (GAASS), and specialist in interventional glaucoma and microinvasive glaucoma surgery (MIGS), performs the GATT technique as a "stand-alone" intervention in the left eye of an 83-year-old pseudophakic patient with uncontrolled moderate pseudoexfoliative glaucoma and allergy to multiple antiglaucoma drops. The preoperative intraocular pressure (IOP) was 32 mm Hg on oral acetazolamide 250mg BID. The patient had already undergone a combined cataract-goniotomy procedure with Sinskey hook in the contralateral eye, with very good results; hence, the decision to proceed with the same minimally invasive technique. The patient’s recovery was uneventful, and the postoperative IOP remains stable between 12 and 13 mm Hg at 1 month after surgery without any topical or systemic medication.
Read more information and watch the video 👇
https://www.ophthalmica.gr/video-of-the-month-jan-2026/
