Unusual intraoperative separation of the trabecular meshwork during gonioscopy-assisted transluminal trabeculotomy

Gonioscopy-assisted transluminal trabeculotomy (GATT) is an angle-based surgical procedure used for the management of glaucoma(¹). We report the case of an 82-year-old female with pseudoexfoliative glaucoma that was refractory to medical treatment and who subsequently underwent GATT.

Following completion of a 270° trabeculotomy, a 120° segment of the trabecular meshwork was observed to be detached and protruding into the inferotemporal angle (Figure 1, black arrows). This unusual intraoperative finding was not associated with any subsequent surgical complications. To the best of our knowledge, only one similar case has been reported previously(¹), underscoring the exceptional rarity of this event.

Figure 1.
Intraoperative view showing an unusual separation of the trabecular meshwork (TM) during GATT. A detached segment of the trabecular meshwork protrudes into the inferotemporal angle (black arrows)

• Funding:
  This study received no specific financial support.

Data Availability Statement:

The datasets generated and/or analyzed during the current study are included in the manuscript.

REFERENCE

• ^1. Dönmez Gün R, Kuu S, Erkan M, Şimşek S. Partial Schlemm canal, trabecular meshwork, and descemet membrane separation during gonioscopy-assisted transluminal trabeculotomy: a case report. J Glaucoma. 2020;29(1):E1–2.

Edited by

• Edited by
  Editor-in-Chief: Newton Kara-Júnior

• Associate Editor:
  Carlos Augusto Moreira Neto

Publication Dates

• Publication in this collection
  31 July 2026
• Date of issue
  2026

History

• Received
  27 Apr 2026
• Accepted
  27 May 2026