GATT: a pioneering procedure to treat severe glaucoma

Over in a blink of an eye: pioneering techniques in glaucoma surgery

Written by: Mr Imran Masood
Published: | Updated: 12/08/2018
Edited by: Laura Burgess

For the last 50 years, experts have been treating severe glaucoma with an operation called a trabeculectomy. But that looks set to change thanks to a brand new treatment which has just reached the UK. We spoke to expert ophthalmologist Mr Imran Masood, who introduced the latest procedure, to find out what patients can expect...

How is severe glaucoma traditionally treated?

When a patient has glaucoma and they haven’t responded to eye drops or laser treatment, surgery is often recommended.

The most common procedure offered is called a trabeculectomy. This involves making a cut in the eye to deal with the excess fluid that’s causing pressure in the eye, and let it drain out.

This procedure can take about an hour, and often requires putting the patient to sleep. It also requires cutting a small drainage hole in the white of the eye under the upper eyelid. Although generally more successful than laser treatment or eye drops, the operation can scar resulting in the need for further surgery to remove the scar tissue.
 

What is the new treatment that you’re offering for glaucoma?

The new procedure is called a GATT (Gonioscopy-Assisted Transluminal Trabeculotomy). It was pioneered in Texas and after observing and mastering the technique over the past year, I am now able to offer the procedure in the UK.

To drain the excess fluid from the eye, we pass in a catheter just 1mm thick. This goes into and dilates Schlemms canal, it then removed using a technique which creates a “360 degree” trabeculotomy i.e removes the barrier to fluid flow into Schlemm’s canal. This essentially makes use of the eye’s natural drainage system with minimal incisions made.

The full procedure takes just 15 minutes, and the patient is awake throughout. Some of our patients have been surprised when told that the procedure was already over. It’s a day case procedure, so you can go home the same day.
 

Where is the treatment available?

Our clinic in Birmingham is the only place in the country that offers the procedure. We are aiming to train other surgeons in this procedure and are confident that take-up will be significant, given the success rates we’re seeing.

By Mr Imran Masood
Ophthalmology

Mr Imran Masood is a highly skilled consultant ophthalmic surgeon in Birmingham, specialising in complex cataract surgery and complex glaucoma surgery, and is a national leader in minimally invasive glaucoma surgery. A leading figure in his field, Mr Masood was one of the first surgeons in the UK to utilise the iStent device, and has now completed more successful iStent implant procedures in complex glaucoma patients than any other doctor in the UK. Ever the pioneer, he continues to research, develop and refine these techniques.

Mr Masood trained at the prestigious Moorfields Eye Hospital in London and was awarded the Fellowship of the Royal College of Ophthalmologists. He is now the director of both the Glaucoma Service at the Birmingham and Midland Eye Centre and the Birmingham Institute of Glaucoma Research, and holds the positions of Honorary Senior Clinical Lecturer and Honorary Consultant Ophthalmologist at the University of Birmingham.

Mr Masood prides himself in delivering the highest quality patient care possible. Despite the complexity of the procedures he carries out, his complication rate is way below the national average, making him one of the top ophthalmologists for glaucoma patients in the country.

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