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Ophthalmic Images
February 9, 2017

Ultrasound Biomicroscopy of Anterior Chamber Angle Structures After Gonioscopy-Assisted Transluminal Trabeculotomy

Author Affiliations
  • 1Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor
JAMA Ophthalmol. 2017;135(2):e164931. doi:10.1001/jamaophthalmol.2016.4931

A woman in her 40s with primary open-angle glaucoma was found to have worsening of her visual field despite maximum-tolerated medical therapy and an intraocular pressure of 30 mm Hg. Because of the patient’s young age and frequent heavy lifting/bending associated with her job, the decision was made to undergo gonioscopy-assisted transluminal trabeculotomy (GATT) as a means of further reducing intraocular pressure. The Schlemm canal was cannulated using an ab interno approach and the iTrack catheter (iScience International). Once in place, the catheter was pulled, exposing the Schlemm canal.1,2 The patient’s surgery was uncomplicated and postoperative eye pressure was 9 mm Hg. Post-GATT ultrasound biomicroscopy images (Figure) highlight the altered anterior chamber angle anatomy with 360° of opened Schlemm canal.

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