Further Modification of the Polypropylene Modified GATT Technique Described

A modification of the polypropylene modified GATT technique was described by Patrick Gooi, MD, founder of Cloudbreak Eye Care in Calgary during the American Society of Cataract and Refractive Surgery’s 2018 annual meeting in Washington, DC. 

In addition to providing step by step instructions for the procedure–which you can learn more about here–he reviewed the following important considerations:

• GATT can be used for patients who are phakic or along with cataract surgery.
• It can be performed after iStents. Remove the stents with MST microtyers/iris forceps; additional goniotomy is not necessary. 
• Elevate the patient’s head 15 to 20 degrees. 
• When combining with phacoemulsification, perform phaco, then GATT, since the heme reflux post-GATT tends to make phaco more difficult.
• When combining with other anterior/posterior segment procedures, perform GATT last.
• Use a low volume 3 cc retrobulbar block for anesthesia with 5 min of Honan balloon afterwards for the first 15 to 20 cases while learning to perfect the procedure.

Gooi P. MIGS part A. Talk presented at: 2018 ASCRS-ASOA Annual Meeting; April 13-17, 2018; Washington, DC.