Gonioscopy Assisted Transluminal Trabeculotomy (GATT) is a newer surgical treatment for glaucoma that is safer and very effective. When the drainage pathways for fluid inside of the eye are not working effectively, this procedure will help to reduce intraocular pressure by restoring the natural outflow pathway. GATT is an outpatient procedure, which takes less than one hour and is usually completed with local anaesthesia and optional intravenous sedation. During the procedure, the ophthalmologist creates a very small incision to access Schlemm’s canal (the eye’s natural drainage system). A micro-catheter or suture is then passed 360 degrees through the canal, creating a loop. As this loop is externalized from the eye, it opens the trabecular meshwork from the inside, and the trabeculotomy is now complete. Removal of the trabecular meshwork enhances the natural pathway for aqueous outflow into Schlemm’s canal, decreasing intraocular pressure.

There are several benefits to the GATT procedure as compared to the traditional trabeculectomy. GATT allows access to all of Schlemm’s Canal and the trabecular meshwork without an incision of the conjunctiva and sclera. The procedure is less invasive; there is less scar tissue, no formation of a conjunctival bleb, and fewer post-operative complications. Further down the road, it is still possible to perform traditional glaucoma surgery if it is necessary. GATT is considered a MicroInvasive Glaucoma Surgery (MIGS) that is capable of managing high pressures without forming a bleb.