Evaluation of prolonged use of topical glaucoma medications on gonioscopy-assisted transluminal trabeculotomy outcomes in juvenile open-angle glaucoma

To evaluate the impact of prolonged use of topical glaucoma medications on the surgical outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) in juvenile open-angle glaucoma (JOAG). This multicenter retrospective study included 100 eyes of 77 JOAG patients who underwent GATT with at least 12 months of follow-up. Patients were categorized into the short-duration (≤ 1.5 years) and long-duration (> 1.5 years) groups. Intraocular pressure (IOP), glaucoma medications, and complications were recorded at baseline and the final visit. Success was defined as a postoperative IOP ≤ 21 mmHg (criterion A), ≤ 18 mmHg (criterion B), or ≤ 15 mmHg (criterion C). Complete and qualified successes were defined as meeting these criteria without and with medications, respectively. The mean age of the participants was 23.2 ± 8.6 years with a mean follow-up of 14.2 ± 4.1 months. Qualified and complete success rates for the short-duration and long-duration groups were 98.0 % and 92.0 % (P = 0.369), 80.0 % and 66.0 % (P = 0.322) for criterion A; 92.0 %, and 68.0 % (P = 0.006), 78.0 % and 50.0 % (P = 0.021) for criterion B; 66.0 % and 40.0 % (P = 0.013), 58.0 % and 30.0 % (P = 0.015) for criterion C. The short-duration group had a significantly lower final IOP than the long-duration group (P = 0.011). No significant differences were observed in final medication and complications. Prolonged use of topical glaucoma medications may reduce the efficacy of GATT in achieving lower IOP in JOAG. Early surgical intervention may contribute to better postoperative outcomes.