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Review Citation - WoS: 9Citation - Scopus: 11Current Surgical Techniques for the Management of Pediatric Glaucoma: a Literature Review(Frontiers Media Sa, 2023) Aktas, Zeynep; Ikiz, Gokcen Deniz Gulpinar; Surgical Sciences; Surgical SciencesPediatric glaucoma surgery is challenging due to its diverse and complex pathophysiology, altered anterior segment anatomy, greater potential for failure, and complications compared to adult patients. Moreover, numerous challenges are associated with long-term postoperative management. Thus, when dealing with childhood glaucoma, it is important to consider the potential complications in addition to the benefits of each intervention. The purpose of this article is to review recently published literature to shed light on the most recent surgical techniques for the safe and effective treatment of childhood glaucoma. Current literature shows that goniotomy and trabeculotomy are the first choices for the management of primary congenital glaucoma. Although older children with phakic eyes seem to benefit from trabeculectomy with adjunctive mitomycin C, it carries a long-term risk of bleb-related endophthalmitis. Glaucoma drainage devices may be preferred for patients with secondary or refractory glaucoma. However, hypotony or tube-related complications are common and encountered more often in children than in adults. Cyclodestructive procedures are also an option for cases in which filtering surgery has failed, but they can also be used as a temporizing measure to reduce the rate of complications in high-risk patients. However, their outcomes can be unpredictable, in terms of efficiency and complications. Finally, minimally invasive glaucoma surgery (MIGS) as the sole alternative treatment or as an adjunctive surgical procedure is a relatively new path for pediatric patients.Article Surgical Treatment of a Patient With Recurrent Bleb Leak and Glaucoma: Bleb Excision Combined With Gonioscopy-Assisted Transluminal Trabeculotomy(Galenos Publ House, 2022) Boluk, Ceyda Eristi; Aktas, ZeynepHere we present a case of intermittent bleb leakage with increased intraocular pressure (IOP) during recovery periods that was treated with gonioscopy-assisted transluminal trabeculotomy (GATT) combined with avascular bleb excision. A 60-year-old woman exhibiting simultaneous leaking bleb and glaucoma underwent GATT and bleb revision. At her final visit, the bleb leakage had resolved and IOP was under control without any further antiglaucoma medication. GATT may be useful for glaucoma patients exhibiting intermittent bleb leakage after failed trabeculectomy.Article Citation - WoS: 1Citation - Scopus: 1Gonioscopy-Assisted Transluminal Trabeculotomy Versus Bent Ab Interno Needle Goniectomy in Patients With Open-Angle Glaucoma(Galenos Publ House, 2025) Ucgul, Ahmet Yucel; Ucgul, Rukiye Kilic; Aktas, ZeynepAmaç: Açık açılı glokomlu (AAG) hastalarda gonyoskopi yardımlı translüminal trabekülotomi (GATT) ile eğik iğne ab interno gonyektominin (BANG) etkinlik ve güvenliğini karşılaştırmak. Gereç ve Yöntem: Bu retrospektif karşılaştırmalı çalışma, GATT (34 göz) veya BANG (31 göz) uygulanan AAG tanılı 65 gözü içermektedir. Göz içi basınç (GİB), başlangıçta ve postoperatif takip vizitlerinde Goldmann applanasyon tonometresi ile ölçüldü. Cerrahi başarı, kısmi (GİB ≤21 mmHg ve ≥%20 azalma) ve tam (aynı kriterler ilaçsız) olarak kategorize edildi. Komplikasyonlar ve ek cerrahi gereksinimi not edildi. Bulgular: Ameliyat öncesi ortalama GİB, GATT grubunda 32,9±6,1 mmHg iken, BANG grubunda 31,8±5,4 mmHg idi. Son kontrolde, GATT grubunda ortalama GİB 15,8±4,5 mmHg’ye düşerken (%51,9 azalma), BANG grubunda 17,9±5,7 mmHg’ye (%43,7 azalma) düştü. Tam cerrahi başarı oranı GATT prosedürü için %88,2, BANG prosedürü için %61,3’tü. Erken cerrahi başarısızlıklar BANG grubunda daha sık görülürken, GATT grubunda erken başarısızlıklar daha nadir olsa da, geç dönemde cerrahi başarısızlıklar BANG grubuna göre daha sık izlendi. Her iki prosedürde de minimal komplikasyonlar görülmüş olup; en yaygın komplikasyon ise geçici hifemaydı. Sonuç: Bu çalışmada, GATT cerrahisinin, BANG cerrahisine kıyasla daha büyük ve daha sürdürülebilir GİB azalması sağladığı ve daha yüksek cerrahi başarı oranlarına sahip olduğu dikkate alındığında, AAG’nin yönetiminde GATT’ın daha güvenilir bir seçenek olduğu söylenebilir.
