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A 360° Glaucoma Procedure Beat Simple Needle Goniotomy at 2 Years — How Effective Is GATT Really? · Glaucoma, Vision & Longevity: Supplements & Science

• 0:00
  SPEAKER_00: A 306 degrees glaucoma procedure beats simple needle goniotomy at two years.
• 0:04
  SPEAKER_00: How effective is GAT really?
• 0:07
  SPEAKER_00: Introduction.
• 0:09
  SPEAKER_00: Opening the eye's natural drainage pathway all the way around sounds as though it should lower pressure more than opening only one small section.
• 0:16
  SPEAKER_00: A randomized trial published on September 28, 2026, offers a rare direct comparison.
• 0:23
  SPEAKER_00: Gonioscopy-assisted transluminal trabeculotomy, which opens the drainage pathway through 360 degrees versus a 90-degree procedure using a bent needle.
• 0:33
  SPEAKER_00: At two years, the full circle procedure had better average pressure and medication results.
• 0:39
  SPEAKER_00: But the trial does not prove that treating more degrees alone caused the advantage.
• 0:44
  SPEAKER_00: The treatments differed in both extent and technique, and the study was small.
• 0:49
  SPEAKER_00: Its results support gonioscopy-assisted transluminal tubeculotomy as a promising option for selected patients, not as a guarantee of very low pressure or freedom from future treatment.
• 1:01
  SPEAKER_00: The 2026 randomized trial by Ayub and Costa, what the randomized trial actually studied.
• 1:08
  SPEAKER_00: The trial enrolled 45 eyes from 34 adults at two centers in Brazil.
• 1:13
  SPEAKER_00: Participants had mild to moderate primary open angle glaucoma, were 40 to 80 years old, had already undergone cataract surgery, and were using no more than three pressure-lowering medicines.
• 1:24
  SPEAKER_00: Their treated pressure had to be at least 18 millimeters of mercury at two visits.
• 1:29
  SPEAKER_00: The researchers assigned 23 eyes to gonioscopy-assisted transluminal trabeculotomy, GATT, and 22 to bent abinterno needle goniotomy, bang.
• 1:41
  SPEAKER_00: Patients were masked to their procedure, but the surgeons and examiners could identify it.
• 1:46
  SPEAKER_00: The same experienced surgeon performed all operations.
• 1:49
  SPEAKER_00: In the full circle procedure, the surgeon passed a suture around Schlem's canal and pulled it through, opening the trabecular mesh work through 360 degrees.
• 1:59
  SPEAKER_00: The needle procedure removed a strip of tissue over approximately 90 degrees of the nasal angle.
• 2:06
  SPEAKER_00: So this was not a comparison of the same operation at two different widths.
• 2:10
  SPEAKER_00: Both the instrument and the amount of tissue treated differed.
• 2:14
  SPEAKER_00: Trial meds and eligibility criteria.
• 2:17
  SPEAKER_00: Baseline pressure, two different starting points.
• 2:20
  SPEAKER_00: Before surgery, the average pressure while patients were still using their medicines was 19.87 mm of mercury in the GAT group and 21.18 in the BANG group.
• 2:31
  SPEAKER_00: After a medication washout, the averages were much higher and almost identical, 25.43 and 25.55 respectively.
• 2:40
  SPEAKER_00: The difference between the groups, treated pressures was not statistically significant, but it matters when interpreting percentage reductions.
• 2:49
  SPEAKER_00: The average medication burden was also similar.
• 2:52
  SPEAKER_00: 2.35 medicines in the GATT group and 2.41 in the Bang group.
• 2:57
  SPEAKER_00: Participants were mostly older adults, with an average age of about 73.
• 3:02
  SPEAKER_00: The average visual field loss was mild, and all eyes were pseudophagic, meaning they had an artificial lens after cataract surgery.
• 3:10
  SPEAKER_00: Baseline data reported for the trial.
• 3:12
  SPEAKER_00: Two-year results.
• 3:14
  SPEAKER_00: GATT did better, but the details matter.
• 3:16
  SPEAKER_00: At 24 months, average pressure was 15.41 mm of mercury after GATT and 17.79 after bang.
• 3:24
  SPEAKER_00: The paper reported reductions from the on-treatment baseline of 22.44% and 16.0%, respectively.
• 3:32
  SPEAKER_00: Because the GATT group started with a treated average about 1.3 millimeters lower, the difference in the absolute change from those baselines was smaller than the endpoint pressure gap.
• 3:42
  SPEAKER_00: Approximately 4.46 millimeters of reduction for GATT and 3.39 millimeters for BAG, or roughly 1.1 millimeters more reduction for GATT.
• 3:53
  SPEAKER_00: The clearest difference was medication use.
• 3:55
  SPEAKER_00: At two years, the GATT group averaged 0.71 medicines down from 2.35, while the Bang group averaged 2.26 down from 2.41.
• 4:06
  SPEAKER_00: That is a reported reduction of 69.78% versus 6.22%.
• 4:11
  SPEAKER_00: 11 GATT eyes and two BANG eyes were medication free.
• 4:15
  SPEAKER_00: The trial's complete success measure was stricter than simply reaching a particular pressure.
• 4:20
  SPEAKER_00: An eye needed to be at or below 18 millimeters of mercury, have at least a 20% reduction, and be off medication.
• 4:27
  SPEAKER_00: Qualified success used the same pressure criteria but allowed medication without increasing the number used at baseline.
• 4:34
  SPEAKER_00: At 24 months, the paper reported 55.5% after bang.
• 4:41
  SPEAKER_00: Qualified success was 64.7% versus 13.6% in the article's results text.
• 4:48
  SPEAKER_00: Its abstract gives 11.4% for bang.
• 4:51
  SPEAKER_00: That small inconsistency is worth noting rather than smoothing over.
• 4:54
  SPEAKER_00: Four GAT eyes reached 12 millimeters of mercury or lower, compared with none after bang.
• 5:01
  SPEAKER_00: 4 out of 23 randomized GAT eyes is about 17%.
• 5:05
  SPEAKER_00: Four out of 17 GAT eyes completing follow-up is about 24%.
• 5:10
  SPEAKER_00: Those are simple count-based proportions, not a robust estimate of what an individual patient's chance would be.
• 5:16
  SPEAKER_00: The trial's Kaplan Meyer estimates and its raw eye counts use different methods and denominators.
• 5:21
  SPEAKER_00: Two-year pressure, medication, target, and success results.
• 5:26
  SPEAKER_00: Follow-up measurements.
• 5:28
  SPEAKER_00: Patients were scheduled for visits on postoperative days 1, 7, 15, 30, 60, 90, 180, 360, 540, and 720.
• 5:40
  SPEAKER_00: The journal article's searchable main text gives exact average pressures at inclusion and at 12 and 24 months.
• 5:46
  SPEAKER_00: Earlier visit averages were also reported in a conference abstract from the same study.
• 5:51
  SPEAKER_00: The table below shows those available interim values with the peer-reviewed journal article's numbers used for the final 24-month row.
• 5:58
  SPEAKER_00: The conference report and final paper differ slightly in some late values.
• 6:02
  SPEAKER_00: The final paper should take precedence.
• 6:05
  SPEAKER_00: Neither source's summary gives exact day 15 and day 60 averages.
• 6:09
  SPEAKER_00: For the full table, please open this article on VisualFieldTest.com.
• 6:15
  SPEAKER_00: Pressure is in millimeters of mercury, figures after pylas are standard deviations.
• 6:20
  SPEAKER_00: The day 1 through day 540 values come from the conference report, final 24-month values come from the journal article.
• 6:28
  SPEAKER_00: Conference report, final journal article.
• 6:31
  SPEAKER_00: The pressure rise at day 30 in both groups is a reminder that early postoperative readings can fluctuate.
• 6:38
  SPEAKER_00: In this trial, medicines were not restarted until day 30.
• 6:42
  SPEAKER_00: Afterwards, treatment was reintroduced under a specified protocol if pressure remained above 18 at consecutive visits.
• 6:50
  SPEAKER_00: Early and late averages therefore need to be interpreted in light of the medication schedule, not as measurements taken under identical conditions at every visit.
• 6:59
  SPEAKER_00: Trial follow-up and medication protocol, loss to follow-up, additional procedures, and safety.
• 7:06
  SPEAKER_00: By 24 months, 19 of 22 bang eyes and 17 of 23 GATES had completed follow-up.
• 7:13
  SPEAKER_00: Three Bang Eyes left the protocol because they needed additional glaucoma surgery.
• 7:18
  SPEAKER_00: Six GATEs did not complete it.
• 7:20
  SPEAKER_00: Four needed additional surgery, one had a retinal detachment at day 30, and one patient died.
• 7:26
  SPEAKER_00: Seven eyes had a reoperation, three bang eyes and four GATEs.
• 7:31
  SPEAKER_00: All three bang reoperations were bleb needlings.
• 7:34
  SPEAKER_00: In the GAT group, three were needlings, and one was a trabeculectomy.
• 7:38
  SPEAKER_00: The trial reported no statistically significant difference between groups.
• 7:43
  SPEAKER_00: Needling is a procedure to revise an existing filtering bleb, so these events should not be read as seven newly created blebs from the angle operations themselves.
• 7:52
  SPEAKER_00: The study's failure definition included additional glaucoma surgery.
• 7:56
  SPEAKER_00: Follow-up and reoperation results, at least one complication was recorded in 12 bang eyes, 54.5%, and 17 GAT eyes, 73.9%.
• 8:08
  SPEAKER_00: Iris damage was the most common complication during surgery, and transient hyphema, blood in the front chamber of the eye, was the most common early postoperative problem.
• 8:18
  SPEAKER_00: One GAT eye had a total hyphema on day one.
• 8:21
  SPEAKER_00: It cleared within a week without intervention.
• 8:24
  SPEAKER_00: The retinal detachment occurred 30 days after GAT, but one event in a small study cannot establish that the operation caused it.
• 8:32
  SPEAKER_00: The article also reported a bang eye with persistent corneal edema and cystoid macular edema associated with vitreous prolapse and a poorly positioned artificial lens.
• 8:42
  SPEAKER_00: Some eyes in both groups showed notable reductions in corneal endothelial cell counts.
• 8:47
  SPEAKER_00: At two years, average counts were 1,561, 88 cells per square millimeter after GATT and 1,077.56 after bang.
• 8:58
  SPEAKER_00: The difference between groups was not statistically significant.
• 9:01
  SPEAKER_00: At least a 20% reduction occurred in 30.4% of GATT eyes and 22.7% of Bang eyes.
• 9:08
  SPEAKER_00: These small sample findings warrant follow-up.
• 9:11
  SPEAKER_00: No significant difference does not establish that either procedure has no effect on the cornea.
• 9:16
  SPEAKER_00: Complications and endothelial cell results.
• 9:19
  SPEAKER_00: Does opening more degrees produce more pressure reduction?
• 9:23
  SPEAKER_00: Why a 360-degree opening might help?
• 9:26
  SPEAKER_00: The trabecular meshwork is part of the eye's main fluid drainage route.
• 9:31
  SPEAKER_00: In open angle glaucoma, resistance in this pathway is often too high.
• 9:35
  SPEAKER_00: GET opens the meshwork around the full circumference of Schlem's canal, whereas the trials bang procedure treated about 90 degrees.
• 9:43
  SPEAKER_00: A wider opening could help by reducing resistance over a larger area, reaching more of the eye's drainage channels, and providing alternative routes if some regions drain poorly.
• 9:54
  SPEAKER_00: Outflow is uneven around the eye, so a small opening may happen to reach a less useful region, or it may reach a particularly effective one.
• 10:03
  SPEAKER_00: Healing and scarring could also affect how long any opening stays useful.
• 10:07
  SPEAKER_00: These are plausible explanations, not mechanisms proven by this trial.
• 10:12
  SPEAKER_00: Trial discussion of treatment extent and regional drainage.
• 10:16
  SPEAKER_00: The broader evidence does not show a simple more degrees, more pressure drop rule.
• 10:21
  SPEAKER_00: The 2026 trial is consistent with the idea that full circle treatment can outperform a small sectoral procedure, but it cannot separate the effect of 360 degrees from the effect of using a suture-based trabeculotomy rather than a bent needle tissue removal technique.
• 10:39
  SPEAKER_00: Evidence comparing treatment extents is mixed.
• 10:42
  SPEAKER_00: A randomized trial comparing 180 and 360 degree internal suture trabeculotomy did not establish a simple, reliable advantage from treating the full circle.
• 10:53
  SPEAKER_00: Randomized 180 versus 360-degree trial, a multi-center comparison of 120 and 360-degree goniotomy for primary open-angle glaucoma found broadly similar pressure lowering, with hyphema more common after complete treatment.
• 11:09
  SPEAKER_00: This was not the same as randomizing patients to identical operations that differed only in extent.
• 11:15
  SPEAKER_00: Multicenter partial versus complete goniotomy study.
• 11:19
  SPEAKER_00: A 206-eye observational study found similar outcomes after partial 180 or 270-degree GATT and full 360-degree GATT.
• 11:28
  SPEAKER_00: Because treatment allocation was not randomized, it cannot rule out differences in which eyes were selected for each extent.
• 11:36
  SPEAKER_00: Partial versus complete GATT study.
• 11:38
  SPEAKER_00: In juvenile open angle glaucoma, a study of 120, 240, and 360-degree goniotomy found the two wider treatments performed similarly and better than 120 degrees at six months.
• 11:51
  SPEAKER_00: That result may not apply to older adults with primary open angle glaucoma.
• 11:57
  SPEAKER_00: Juvenile Glaucoma Extent Study, a review of angle procedures, similarly describes studies in which sectoral and circumferential treatments achieved comparable results.
• 12:06
  SPEAKER_00: Taken together, the evidence suggests that extent may matter in some settings, but not in a predictable linear dose response.
• 12:14
  SPEAKER_00: The health and location of the downstream drainage channels, the type of glaucoma, the operation used, and the patient's starting pressure all matter.
• 12:24
  SPEAKER_00: Review of evidence on treating versus preserving the trabecular meshwork.
• 12:29
  SPEAKER_00: How effective is GATT compared with other glaucoma treatments?
• 12:32
  SPEAKER_00: The numbers below are not head-to-head rankings.
• 12:35
  SPEAKER_00: The studies vary in baseline pressure, medication washout, cataract surgery, glaucoma type, success definition, and follow-up.
• 12:43
  SPEAKER_00: In particular, a pressure measured while taking medicines is not directly comparable with an unmedicated pressure after washout.
• 12:51
  SPEAKER_00: For the full table, please open this article on visualfieldtest.com.
• 12:55
  SPEAKER_00: What can we say about reaching 15 or 12?
• 12:58
  SPEAKER_00: The GATT trial reported that 29.3% met its additional success definition of pressure at or below 15 plus at least a 20% reduction.
• 13:08
  SPEAKER_00: That is not the same as the probability of simply measuring 15 or lower at one visit.
• 13:13
  SPEAKER_00: The four GATT eyes that reach 12 or lower are a useful signal, but too few to provide a stable estimate.
• 13:20
  SPEAKER_00: Other studies often report pressure at or below 18 percentage reduction or success under their own rules, not the same thresholds.
• 13:28
  SPEAKER_00: For eye stent, hydris, cannilplasty, laser, and other angle procedures, the literature does not provide a consistent, directly comparable probability of reaching 15 or 12.
• 13:40
  SPEAKER_00: A precise league table of those probabilities would imply more comparability than the studies allow.
• 13:47
  SPEAKER_00: Why trabecular procedures have a pressure ceiling?
• 13:50
  SPEAKER_00: The eye's conventional drainage route ends in veins around the outside of the eye.
• 13:55
  SPEAKER_00: The pressure in those episcleral veins is commonly around 8 to 10 millimeters of mercury.
• 14:01
  SPEAKER_00: Removing resistance at the trabecular meshwork can improve flow, but it does not remove resistance farther downstream or the pressure in the receiving veins.
• 14:11
  SPEAKER_00: A simplified pressure-flow relationship therefore predicts a physiological limit for procedures that rely on the eye's natural drainage route.
• 14:19
  SPEAKER_00: Reviews of eye fluid dynamics also describe meaningful resistance beyond the trabecular meshwork, including around Schlem's canal and its collector channels.
• 14:29
  SPEAKER_00: Trabeculectomy works differently.
• 14:32
  SPEAKER_00: It creates a new route that drains fluid outside the usual pathway and can therefore achieve lower pressures.
• 14:38
  SPEAKER_00: Review of aqueous humor dynamics.
• 14:41
  SPEAKER_00: Review of minimally invasive glaucoma surgery and pressure limits.
• 14:46
  SPEAKER_00: The 8 to 10 figure is not a guaranteed GAT floor.
• 14:50
  SPEAKER_00: It is an estimate of the downstream venous pressure, and real eyes have additional resistance.
• 14:55
  SPEAKER_00: A practical expectation after successful GAT is generally a pressure in the mid-teens, with some eyes reaching the low teens, sometimes with medicines.
• 15:04
  SPEAKER_00: A sustained pressure of 12 or lower is possible in a subset.
• 15:08
  SPEAKER_00: A single-digit result from GAT alone is not a dependable goal.
• 15:12
  SPEAKER_00: If advanced or rapidly progressing glaucoma needs a very low target, a filtering operation may be more appropriate despite its greater risks.
• 15:21
  SPEAKER_00: GATT four-year results.
• 15:23
  SPEAKER_00: Physiology of episcleral venous pressure.
• 15:25
  SPEAKER_00: Which patients may do better with GATT.
• 15:28
  SPEAKER_00: Several factors may affect results, but the evidence is uneven.
• 15:32
  SPEAKER_00: Starting pressure.
• 15:33
  SPEAKER_00: A higher starting pressure can allow a larger numerical reduction, but it does not guarantee success.
• 15:39
  SPEAKER_00: In a four-year GATT series, higher baseline pressure was associated with a modestly higher risk of failure.
• 15:45
  SPEAKER_00: For your study.
• 15:47
  SPEAKER_00: Age and disease severity.
• 15:49
  SPEAKER_00: Studies have not consistently agreed on whether age or glaucoma stage predicts success.
• 15:54
  SPEAKER_00: 153 eye study found that glaucoma stage did not appear to affect success, while studies in other populations report different risk patterns.
• 16:03
  SPEAKER_00: Prognostic factor study, previous laser lens status, and combined cataract surgery, the randomized trial included only eyes that had already undergone cataract surgery.
• 16:14
  SPEAKER_00: Its results cannot establish whether GAT performs similarly in phic eyes or when combined with cataract surgery.
• 16:21
  SPEAKER_00: The available evidence does not establish previous selective laser trabeculoplasty as a reliable predictor of GATT success.
• 16:28
  SPEAKER_00: Blood reflux and hyphema.
• 16:31
  SPEAKER_00: Blood reflux can indicate communication with the drainage pathway, but it is not a proven guarantee of durable success.
• 16:37
  SPEAKER_00: Mild transient blood is common after trabecular procedures.
• 16:41
  SPEAKER_00: A prognostic study found that postoperative macrohyphema could be associated with poorer success.
• 16:47
  SPEAKER_00: Prognostic factor study.
• 16:50
  SPEAKER_00: Pigmentation.
• 16:51
  SPEAKER_00: Results from this trial do not answer whether heavily pigmented angles change GAT outcomes.
• 16:57
  SPEAKER_00: Pigmentary glaucoma should not be assumed to have the same risk-benefit profile as the trial's primary open angle glaucoma population.
• 17:05
  SPEAKER_00: As a result, a plausible GAT candidate is someone with an open angle, mild to moderate glaucoma, and a target pressure that may be met in the low to mid-teens, particularly if reducing medication burden and preserving the conjunctiva for possible future surgery are priorities.
• 17:22
  SPEAKER_00: It is less reassuring as a sole plan when the optic nerve needs a very low pressure quickly.
• 17:28
  SPEAKER_00: How much confidence should we place in the trial?
• 17:31
  SPEAKER_00: Observed evidence.
• 17:33
  SPEAKER_00: In this randomized comparison, GATT had better two-year average pressure and medication results than 90-degree bang.
• 17:40
  SPEAKER_00: Its pressure advantage was statistically borderline for the overall time by group analysis, p equal.048, while the medication difference was stronger.
• 17:50
  SPEAKER_00: The trial also found more GATT eyes meeting its success definitions.
• 17:55
  SPEAKER_00: Important limits.
• 17:56
  SPEAKER_00: There were only 45 eyes, and both eyes from some patients were included.
• 18:01
  SPEAKER_00: The researchers used statistical models to account for the correlation between a person's two eyes, but the small sample still makes estimates unstable.
• 18:10
  SPEAKER_00: The GATT group also had more non-completions, including four additional surgeries, a retinal detachment, and a death.
• 18:17
  SPEAKER_00: The procedures could not be masked to examiners, and one surgeon performed all operations.
• 18:23
  SPEAKER_00: The authors themselves noted that the sample limited statistical power for medication outcomes, complications, and survival analysis.
• 18:32
  SPEAKER_00: Trial limitations.
• 18:33
  SPEAKER_00: The treatment extent is another limitation for the central question.
• 18:37
  SPEAKER_00: The comparison was 360-degree suture trabeculotomy versus 90-degree bent needle tissue removal.
• 18:44
  SPEAKER_00: It demonstrates a difference between those two treatment packages.
• 18:48
  SPEAKER_00: It does not prove that a 360-degree version of the same needle procedure would outperform a 90-degree version, or that every additional degree lowers pressure further.
• 18:59
  SPEAKER_00: What might happen in a 500-patient randomized trial?
• 19:03
  SPEAKER_00: The following is an inference, not observed evidence.
• 19:06
  SPEAKER_00: It assumes a study of patients similar to the 2026 trial.
• 19:10
  SPEAKER_00: Pseudophagic adults with mild to moderate primary open angle glaucoma and a treated baseline pressure around 20.
• 19:17
  SPEAKER_00: Average two-year pressure after Gayety, roughly 15.5 to 16.5 mm of mercury.
• 19:23
  SPEAKER_00: Medication reduction, roughly 1.1 to 1.5 medicines on average, leaving many patients on zero or one.
• 19:30
  SPEAKER_00: Medication free at 2 years, perhaps 35 to 50%.
• 19:35
  SPEAKER_00: Pressure of 12 or lower, perhaps 10 to 20%.
• 19:38
  SPEAKER_00: A wide range because the original study recorded only four such eyes.
• 19:43
  SPEAKER_00: Additional glaucoma procedure by two years, perhaps 10 to 20%.
• 19:48
  SPEAKER_00: The original study observed seven reoperations among 45 eyes, but several were bleb needlings.
• 19:53
  SPEAKER_00: A larger trial might produce a different mix.
• 19:56
  SPEAKER_00: Likely five-year durability.
• 19:58
  SPEAKER_00: Many eyes would probably retain some pressure-lowering benefit, but pressure control would not mean permanent freedom from medicines or additional surgery.
• 20:08
  SPEAKER_00: Inference from the four-year observational series suggests that failure and reoperation accumulate with time.
• 20:14
  SPEAKER_00: A reasonable cautious expectation is that a substantial minority will need further treatment by five years.
• 20:21
  SPEAKER_00: In a 500-patient trial, I would expect GATT to retain an advantage over 90 degree bang for medication reduction and probably for average pressure.
• 20:31
  SPEAKER_00: I would not expect the very large success rate difference from the small trial to reproduce exactly.
• 20:37
  SPEAKER_00: A likely average pressure difference may be closer to 1 to 2 mm of mercury than a dramatic separation, and the medication-free advantage could be clinically meaningful without making GATT a substitute for trabeculectomy when a very low target is essential.
• 20:53
  SPEAKER_00: How close can GATT get to trabeculectomy without creating a bleb?
• 20:58
  SPEAKER_00: GATT can be an effective way to lower pressure while preserving the eye's conjunctiva and avoiding a filtering bleb.
• 21:05
  SPEAKER_00: In the randomized two-year trial, its average pressure was about 15.4 millimeters of mercury, and nearly half of the randomized eyes were medication-free by the raw count.
• 21:17
  SPEAKER_00: Larger observational studies also commonly report average pressures in the mid-teens, although longer follow-up brings more failures and additional treatment.
• 21:26
  SPEAKER_00: That is a meaningful result for a patient whose target can be met in the low to mid-teens.
• 21:32
  SPEAKER_00: It is not the same as the pressure-lowering capacity of trabeculectomy.
• 21:37
  SPEAKER_00: Because GATT works through the eye's existing drainage channels, episcleral venous pressure and downstream resistance limit how low pressure can reliably go.
• 21:46
  SPEAKER_00: Low teen pressure is plausible for a good responder.
• 21:50
  SPEAKER_00: A stable pressure of 12 or lower is possible, but not assured.
• 21:53
  SPEAKER_00: Single-digit pressure is not a reliable expectation.
• 21:57
  SPEAKER_00: For people with advanced damage, rapid progression, or a target requiring pressure well below the mid-teens, the greater pressure-lowering potential of trabeculectomy may matter more than the appeal of a bleb-free operation.
• 22:11
  SPEAKER_00: The best choice depends on the individual target pressure, disease severity, drainage anatomy, and tolerance for surgical risk, not simply on whether the procedure treats 90 or 360 degrees.
• 22:23
  SPEAKER_00: All links to sources are available in the text version of this article.
• 22:27
  SPEAKER_00: You can find the full article at visualfieldtest.com.
• 22:32
  SPEAKER_00: Thanks for listening.
• 22:33
  SPEAKER_00: To check your visual field, click the link at the bottom of this article or visit visualfieldtest.com.