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Hemi-GATT was intentionally selected as a planned primary surgical strategy and was not performed as a secondary procedure following failed circumferential GATT. An IOP spike was defined as postoperative IOP\u2009&gt;\u200930\u00a0mm Hg or an increase of \u2265\u200910\u00a0mm Hg from the previous visit. Surgical success was defined as qualified (IOP\u2009\u2264\u200921\u00a0mm Hg and \u2265\u200930% reduction from baseline with or without medication) or complete (without medication). The primary outcome was the incidence and predictors of early IOP spikes; secondary outcomes included surgical success rates and related risk factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      An IOP spike occurred in 11\/42 eyes (26.2%) at 7.1\u2009\u00b1\u20094.8 days postoperatively, lasting 6.7\u2009\u00b1\u20095.1 days; mean peak IOP during spikes was 26.2\u2009\u00b1\u20095.0\u00a0mm Hg. All patients with an IOP spike experienced a decrease in IOP to \u2264\u200921\u00a0mm Hg within the first postoperative month. Spike frequency was lower with hemi-GATT\u2009+\u2009TP than with standard hemi-GATT (1\/14 [7.1%] vs. 10\/28 [35.7%];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048). On multivariable analysis, higher baseline IOP increased spike risk (odds ratio [OR], 1.48; 95% CI, 1.08\u20132.01;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.013), whereas TP reduced it (OR, 0.01; 95% CI, 0.01\u20130.38;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.014). The mean follow-up period was 7.71\u2009\u00b1\u20092.03 months (range: 6\u201313 months). Qualified and complete success did not differ (92.9% vs. 89.3%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.769; 42.9% vs. 35.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.714).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>TP during hemi-GATT significantly decreases early postoperative IOP spikes and enhances early IOP control, while maintaining surgical success.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00417-026-07182-8","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T03:21:02Z","timestamp":1773199262000},"page":"2235-2243","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Intraocular pressure spikes after trabecular meshwork strip peeling during hemi-GATT"],"prefix":"10.1007","volume":"264","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7420-8934","authenticated-orcid":false,"given":"Mehmet Murat","family":"Uzel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Mert","family":"Ko\u00e7er","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bekir Eren","family":"Aksoy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00f6zde","family":"Hondur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"7182_CR1","doi-asserted-by":"publisher","first-page":"2081","DOI":"10.1016\/j.ophtha.2014.05.013","volume":"121","author":"YC Tham","year":"2014","unstructured":"Tham YC, Li X, Wong TY, Quigley HA, Aung T, Cheng CY (2014) Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. 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