Purpose: 
To describe a novel minimally invasive surgical technique for treatment of open-angle glaucoma. Initial papers describe gonioscopic-transluminal trabeculotomy (GATT) as a circumferential procedure. The authors describe a novel procedure with 180-degree trabeculotomy followed by viscoelastic canaloplasty (viscocanaloplasty). 

Methods: Retrospective analysis of hemi-GATT cases with viscocanaloplasty during July 2019 and August 2019. Gender, age, diagnosis, preoperative intraocular pressure (IOP), vision, medications, and visual field parameters were assessed. Outcome variables were IOP, visual acuity, and number of IOP lowering medications.

Results:
This was a pilot project (n=32) of patients undergoing hemi-gonioscopic-assisted transluminal trabeculotomy (Hemi GATT) with direct viscocanaloplasty. The mean age was 68 years (Range 24-87). Preoperatively the mean intraocular pressure (IOP) was 16 mmHg (Range 7-37) and patients were on an average of 2.8 IOP lowering drops. Average daily dose of diamox was 466mg (n=11). IOP lowering was significantly lower at 6 months follow up (p=0.05) with a mean IOP of 13 mmHg. IOP lowering medications were reduced significantly to an average of 1.6. Only one patient remained on diamox (375 mg daily). One patient developed CME and two patients had IOP spikes that were managed medically. 


Conclusion: 
The results suggest that Hemi-GATT with direct viscocanaloplasty provides significant reductions in IOP as well as reduces reliance on oral diamox and topical IOP lowering medications. Ongoing evaluation is required to establish safety and efficacy especially when compared to hemi-GATT alone or circumferential GATT.

Hemi-gonioscopy assisted-transluminal trabeculotomy combined with viscocanaloplasty: Description of a novel technique and preliminary results

[Poster Abstract Booklet](https://drive.google.com/file/d/1AGitRGyG9W0FiZ2Xjz6RNO2h7C0XglOL/view)

[Surgical Video Abstract Booklet](https://drive.google.com/file/d/1B-IkojrZhXk4AgXzsEQyuE_FwPG1Lvpe/view?usp=sharing)

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