Comparative analysis of efficacy and safety between partial and complete gonioscopy‐assisted transluminal trabeculotomy for open‐angle glaucoma

Purpose To compare the surgical efficacy and safety of partial and complete gonioscopy‐assisted transluminal trabeculotomy (GATT) in open‐angle glaucoma. Methods This retrospective comparative study included 206 eyes with primary open‐angle glaucoma (POAG) or pseudoexfoliation glaucoma (PEXG) who underwent partial GATT (superior 180°, inferior 180°, or 270°) or complete GATT (360°) at a tertiary centre with at least 12 months of follow‐up. Surgical success (qualified and complete) was defined across three intraocular pressure (IOP) criteria: A (<18 mmHg), B (<15 mmHg), and C (<12 mmHg), each requiring a ≥30% reduction from baseline. Additional outcomes included best‐corrected visual acuity (BCVA), number of anti‐glaucoma medications (AGMs), extent of episcleral venous fluid wave (EVFW) and postoperative complications. Results Mean follow‐up was 19.7 ± 9.6 months. Baseline demographics, glaucoma type and surgical indications were comparable between groups. At final follow‐up, all GATT variants resulted in significant IOP and AGM reductions ( p < 0.001), with no statistically significant differences in IOP, BCVA, success rates, or complications among the four groups ( p > 0.05). EVFW extent and safety profiles were similar across groups. Conclusion Partial GATT (superior 180°, inferior 180°, or 270°) provides similar surgical outcomes and safety as complete 360° GATT. Hemi‐GATT may serve as a time‐efficient and effective alternative to circumferential GATT in appropriate patients.