{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T22:47:04Z","timestamp":1792622824114,"version":"4.5.0"},"reference-count":18,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T00:00:00Z","timestamp":1740355200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: The aim of this paper was to evaluate the two-year outcomes of phacoemulsification combined with gonioscopy-assisted transluminal trabeculotomy (PHACO-GATT) versus standalone GATT in terms of efficacy, safety, and surgical success. Methods: This retrospective, comparative study included 64 eyes of 64 patients with moderate-to-severe open-angle glaucoma: 35 patients (54.7%) with primary open-angle glaucoma (POAG) and 29 patients (45.3%) with pseudoexfoliative glaucoma (PEG). Group 1 (n = 38) underwent PHACO-GATT, and Group 2 (n = 26) underwent standalone GATT. Data, including intraocular pressure (IOP), the number of anti-glaucomatous medications, and complications, were analyzed preoperatively and postoperatively (1st, 3rd, 6th, 12th, and 24th months). Surgical success was defined as achieving a \u2265 20% IOP reduction or IOP \u2264 21 mmHg with or without medications. Results: The mean age was 74.4 \u00b1 7.2 years in Group 1 and 70.8 \u00b1 7.3 years in Group 2. Both groups achieved significant IOP reductions at the 24-month follow-up: Group 1 from 28.6 \u00b1 6.3 mmHg to 12.7 \u00b1 2.4 mmHg, and Group 2 from 27 \u00b1 4.8 mmHg to 13 \u00b1 1.7 mmHg (both p &lt; 0.001). BCVA in Group 1 improved significantly from 0.77 \u00b1 0.29 logMAR to 0.28 \u00b1 0.13 logMAR at 24 months (p &lt; 0.001), while in Group 2, it remained stable at 0.46 \u00b1 0.19 logMAR at baseline and 0.47 \u00b1 0.19 logMAR at 24 months (p &gt; 0.05). The mean number of anti-glaucoma medications decreased significantly in both groups (p &lt; 0.001) without significant intergroup differences (p &gt; 0.05). Complication-free rates were 68.4% in Group 1 and 69.2% in Group 2 (p = 0.899). Surgical success rates were comparable between groups at 12 (100% in both groups) and 24 months (94.7% in Group 1, 96.2% in Group 2). Conclusions: Both PHACO-GATT and standalone GATT demonstrated comparable efficacy and safety over a two-year period. PHACO-GATT provided significant visual acuity improvements due to cataract extraction, making it a suitable option for patients with coexisting cataracts and glaucoma.<\/jats:p>","DOI":"10.3390\/diagnostics15050542","type":"journal-article","created":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T10:52:47Z","timestamp":1740394367000},"page":"542","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Two-Year Outcomes of Phacoemulsification Combined with GATT Versus Standalone GATT in Open-Angle Glaucoma: A Comparative Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5248-5562","authenticated-orcid":false,"given":"Z\u00fcbeyir","family":"Yozgat","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Kastamonu University, Kastamonu 37150, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0958-9961","authenticated-orcid":false,"given":"Mehmet Cem","family":"Sabaner","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Kastamonu University, Kastamonu 37150, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e1221","DOI":"10.1016\/S2214-109X(17)30393-5","article-title":"Global causes of blindness and distance vision impairment 1990\u20132020: A systematic review and meta-analysis","volume":"5","author":"Flaxman","year":"2017","journal-title":"Lancet Glob. Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2081","DOI":"10.1016\/j.ophtha.2014.05.013","article-title":"Global prevalence of glaucoma and projections of glaucoma burden through 2040: A systematic review and meta-analysis","volume":"121","author":"Tham","year":"2014","journal-title":"Ophthalmology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1007\/s40135-019-00220-1","article-title":"An update on microinvasive glaucoma surgery concurrent with cataract extraction","volume":"7","author":"Chen","year":"2019","journal-title":"Curr. Ophthalmol. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1007\/s00347-021-01520-3","article-title":"Surgical advancement in glaucoma during the past 10 years","volume":"119","author":"Wong","year":"2021","journal-title":"Die Ophthalmol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1016\/j.ophtha.2013.11.001","article-title":"Gonioscopy-assisted transluminal trabeculotomy, ab interno trabeculotomy: Technique report and preliminary results","volume":"121","author":"Grover","year":"2014","journal-title":"Ophthalmology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1097\/IJG.0000000000000956","article-title":"Gonioscopy-assisted transluminal trabeculotomy: An ab interno circumferential trabeculotomy: 24 months follow-up","volume":"27","author":"Grover","year":"2018","journal-title":"J. Glaucoma"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1097\/01.ijg.0000212294.31411.92","article-title":"Three and five year changes in intraocular pressures after clear corneal phacoemulsification in open angle glaucoma patients, glaucoma suspects, and normal patients","volume":"15","author":"Shingleton","year":"2006","journal-title":"J. Glaucoma"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1097\/ICU.0b013e3283360ac3","article-title":"The effect of cataract extraction on intraocular pressure","volume":"21","author":"Shrivastava","year":"2010","journal-title":"Curr. Opin. Ophthalmol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2491","DOI":"10.2147\/OPTH.S267303","article-title":"Combined gonioscopy-assisted transluminal trabeculotomy (GATT) with ab interno canaloplasty (ABiC) in conjunction with phacoemulsification: 12-month outcomes","volume":"14","author":"Alrushoud","year":"2020","journal-title":"Clin. Ophthalmol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1007\/s10792-020-01550-x","article-title":"The efficacy of gonioscopy-assisted transluminal trabeculectomy combined with phacoemulsification","volume":"41","author":"Bozkurt","year":"2021","journal-title":"Int. Ophthalmol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"\u0106wikli\u0144ska-Haszcz, A., \u017barnowski, T., Wr\u00f3bel-Dudzi\u0144ska, D., and Kosior-Jarecka, E. (2023). The Efficacy and Safety of the GATT Procedure in Open-Angle Glaucoma\u20146-Month Results. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20032759"},{"key":"ref_12","first-page":"e195","article-title":"Phacoemulsification with gonioscopy-assisted transluminal trabeculotomy versus phacoemulsification alone in primary angle closure glaucoma: A randomized controlled study","volume":"102","author":"Mettias","year":"2024","journal-title":"Acta Ophthalmol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3257","DOI":"10.1007\/s00417-023-06166-2","article-title":"Hemi-GATT combined with phacoemulsification in patients with moderate-severe primary open-angle glaucoma: 2-year outcomes","volume":"261","author":"Ruparelia","year":"2023","journal-title":"Graefe\u2019s Arch. Clin. Exp. Ophthalmol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1038\/s41433-022-02087-2","article-title":"Gonioscopy-assisted Transluminal Trabeculotomy (GATT) combined phacoemulsification surgery: Outcomes at a 2-year follow-up","volume":"37","author":"Wan","year":"2023","journal-title":"Eye"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1136\/bjophthalmol-2020-315954","article-title":"Outcomes of gonioscopy-assisted transluminal trabeculotomy in pseudoexfoliative glaucoma: 24-month follow-up","volume":"105","author":"Sharkawi","year":"2021","journal-title":"Br. J. Ophthalmol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"505","DOI":"10.4103\/ijo.IJO_1007_18","article-title":"Surgical outcomes of combined gonioscopy-assisted transluminal trabeculotomy and cataract surgery","volume":"67","author":"Baykara","year":"2019","journal-title":"Indian J. Ophthalmol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3009","DOI":"10.2147\/OPTH.S272298","article-title":"Outcomes of combined prolene gonioscopy assisted transluminal trabeculotomy with phacoemulsification in open-angle glaucoma","volume":"14","year":"2020","journal-title":"Clin. Ophthalmol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"3035","DOI":"10.1007\/s00417-021-05133-z","article-title":"Comparison of 1-year surgical outcomes of combined cataract surgery and gonioscopy-assisted transluminal trabeculotomy (GATT) versus cataract surgery and iStent Inject","volume":"259","author":"Hamze","year":"2021","journal-title":"Graefe\u2019s Arch. Clin. Exp. Ophthalmol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/5\/542\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:41:12Z","timestamp":1760028072000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/5\/542"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,24]]},"references-count":18,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["diagnostics15050542"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15050542","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,24]]}}}