{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T08:58:01Z","timestamp":1776416281089,"version":"3.51.2"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the 2-year efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) for normal-tension glaucoma (NTG).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This single-center retrospective case series included 9 NTG patients (12 eyes) undergoing GATT, with follow-up at postoperative day 1, week 1, and months 1, 3, 6, 12, 18, and 24. Primary outcomes were changes in intraocular pressure (IOP) and IOP-lowering medication burden at 24\u202fmonths (counted by active ingredients). Complete and qualified success were assessed using strict criteria (from postoperative month 1 onward: IOP 6\u201315\u202fmmHg and \u226520% reduction from baseline). Postoperative events and additional interventions\/reoperations were recorded. Paired\n                      <jats:italic>t<\/jats:italic>\n                      tests or Wilcoxon signed-rank tests were used as appropriate; a one-eye-per-patient sensitivity analysis was performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median age at surgery was 65 (53\u201370) years, and most eyes had moderate-to-advanced glaucoma. Mean IOP decreased from 17.33\u202f\u00b1\u202f3.53\u202fmmHg to 13.33\u202f\u00b1\u202f2.35\u202fmmHg at 24\u202fmonths (mean reduction 4.00\u202f\u00b1\u202f2.86\u202fmmHg; 95% CI 2.18\u20135.82;\n                      <jats:italic>t<\/jats:italic>\n                      \u202f=\u202f4.844;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), corresponding to a 23.1% reduction. Medication burden decreased from 1 (0, 2) to 0 (0, 0) (\n                      <jats:italic>Z<\/jats:italic>\n                      \u202f=\u202f\u22122.251;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.024). At 24\u202fmonths, qualified and complete success rates were both 50.0% (6\/12); sensitivity analysis (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f9) was consistent. No hypotony, IOP spikes, or serious complications occurred. Events were mild and self-limited (mainly hyphema and aqueous flare). No SLT, needling, or additional glaucoma surgery was required.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>GATT significantly reduced IOP and medication burden in NTG with a safety profile through 24\u202fmonths. Larger prospective studies are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1828249","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T07:58:42Z","timestamp":1776412722000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Two-year clinical outcomes of standalone gonioscopy-assisted transluminal trabeculotomy in normal-tension glaucoma"],"prefix":"10.3389","volume":"13","author":[{"given":"Zhengfang","family":"Wu","sequence":"first","affiliation":[{"name":"Chengdu University of Traditional Chinese Medicine","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suju","family":"Liu","sequence":"additional","affiliation":[{"name":"Chengdu University of Traditional Chinese Medicine","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ping","family":"Yu","sequence":"additional","affiliation":[{"name":"Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Chengdu University of Traditional Chinese Medicine (Chengdu First People\u2019s Hospital), High-Tech Zone","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao","family":"Tang","sequence":"additional","affiliation":[{"name":"Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Chengdu University of Traditional Chinese Medicine (Chengdu First People\u2019s Hospital), High-Tech Zone","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liuzhi","family":"Zeng","sequence":"additional","affiliation":[{"name":"Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Chengdu University of Traditional Chinese Medicine (Chengdu First People\u2019s Hospital), High-Tech Zone","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1111\/ceo.14043","article-title":"Normal-tension glaucoma: current concepts and approaches","volume":"50","author":"Leung","year":"2022","journal-title":"Clin Experiment Ophthalmol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/bjophthalmol-2021-egsguidelines","article-title":"European glaucoma society terminology and guidelines for glaucoma, 5th edition","volume":"105","year":"2021","journal-title":"Br J Ophthalmol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"P71","DOI":"10.1016\/j.ophtha.2020.10.022","article-title":"Primary open-angle glaucoma preferred practice 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Ophthalmol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"CD010746","DOI":"10.1002\/14651858.CD010746.pub2","article-title":"Perioperative medications for preventing temporarily increased intraocular pressure after laser trabeculoplasty","volume":"2017","author":"Zhang","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1007\/s00417-023-06265-0","article-title":"Intraocular pressure spikes after gonioscopy-assisted transluminal trabeculotomy (GATT)","volume":"262","author":"Ben Haim","year":"2024","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1016\/j.survophthal.2019.04.006","article-title":"Ocular hypotony: a comprehensive review","volume":"64","author":"Wang","year":"2019","journal-title":"Surv 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Glaucoma"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"587","DOI":"10.5935\/0004-2749.20210083","article-title":"Gonioscopy-assisted transluminal trabeculotomy (GATT) outcomes in eyes with open-angle glaucoma resistant to maximum treatment","volume":"84","author":"de Faria","year":"2021","journal-title":"Arq Bras Oftalmol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1080\/08820538.2022.2094715","article-title":"Gonioscopy assisted transluminal trabeculotomy: a boon to developing nations\u2014a systematic review","volume":"38","author":"Velamala","year":"2023","journal-title":"Semin Ophthalmol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/s40662-022-00294-2","article-title":"Prospective 12-month outcomes of combined iStent inject implantation and phacoemulsification in Asian eyes with normal tension glaucoma","volume":"9","author":"Ang","year":"2022","journal-title":"Eye Vis 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