Treatment Overview
Gonioscopy-Assisted Transluminal Trabeculotomy (GATT) in Korea is a minimally invasive, blebless glaucoma surgery (MIGS) that opens the eye’s natural drainage system from the inside. Surgeons use a microcatheter or suture to perform a 360° trabeculotomy, removing resistance within the trabecular meshwork and restoring natural aqueous outflow through Schlemm’s canal.
Korea is internationally recognized for excellence in GATT thanks to OCT-angle mapping, 3D digital gonioscopy, illumination-guided catheter navigation, and AI-enhanced canal modeling, providing highly precise, safe, and effective outcomes.
Purpose & Benefits
Purpose
- Restore natural aqueous outflow by removing circumferential trabecular resistance.
- Lower IOP in patients with mild, moderate, or severe glaucoma.
- Prevent further optic nerve damage in progressive cases.
- Provide a minimally invasive, internal approach without forming an external bleb.
Benefits
- Blebless Procedure: No external drainage reservoir needed.
- Minimally Invasive: Internal ab-interno approach through a small corneal incision.
- Strong IOP Reduction: Excellent outcomes, especially in open-angle and secondary glaucomas.
- Fast Healing: Low inflammation and short recovery time.
- Repeatable/Combinable: Can be paired with other MIGS procedures if needed.
- Ideal for Younger Patients: Safely preserves tissue for future options.
Ideal Candidates
GATT in Korea is ideal for:
- Patients with primary open-angle glaucoma (POAG).
- Individuals with juvenile open-angle glaucoma, which responds strongly to GATT.
- Secondary glaucomas, including:
- Pigmentary glaucoma
- Pseudoexfoliative glaucoma
- Steroid-induced glaucoma
- Uveitic glaucoma (controlled)
- Patients wanting to avoid bleb-based surgery.
- Individuals not responding to eye drops or SLT laser.
- Patients undergoing combined cataract + GATT surgery.
Possible Risks & Complications
GATT is extremely safe, but potential risks include:
- Transient hyphema: Small blood reflux that clears naturally.
- Temporary blurred vision: Improves within days.
- Mild inflammation: Easily controlled with medication.
- Short-term IOP fluctuations: Settle over several weeks.
- Canal scarring (rare): Reduced with proper follow-up.
Korean centers minimize risks through angle-OCT guidance, illumination catheters, and AI-calibrated treatment planning.
Types of GATT Procedures in Korea
Standard 360° GATT
A continuous 360° opening of Schlemm’s canal using an illuminated microcatheter.
Suture-Assisted GATT
A suture thread is used when microcatheter access is limited.
Combined Cataract + GATT
Performed during cataract surgery for enhanced IOP reduction.
Hybrid GATT + Canaloplasty
Combines trabeculotomy with canal dilation for stronger outflow.
Image-Guided GATT
Uses OCT and digital gonioscopy for surgical mapping and precision.
Surgical Techniques
AI-Guided Angle and Canal Evaluation
Considers canal resistance, width, and trabecular thickness to plan the incision.
Ab Interno Micro-Incision
A 1–2 mm corneal incision gives access to the drainage angle.
Gonioscopic Visualization
A high-definition gonio lens provides real-time visualization of Schlemm’s canal.
360° Cannulation
An illuminated microcatheter or fine suture is threaded around the entire canal.
Circumferential Trabeculotomy
The catheter is withdrawn, opening the trabecular meshwork completely.
OCT-Based Confirmation
Ensures uniform canal opening and enhanced aqueous flow.
Treatment Process in Korea
Step 1 – Comprehensive Glaucoma Evaluation
Includes IOP testing, OCT imaging, gonioscopy, and visual field analysis.
Step 2 – Personalized Surgical Planning
Surgeon determines catheter type, entry point, and whether to combine GATT with cataract surgery.
Step 3 – GATT Procedure
A micro-incision is created, the canal is cannulated 360°, and the trabecular meshwork is opened.
Step 4 – Immediate Postoperative Check
IOP is monitored, and anti-inflammatory drops are started.
Step 5 – Follow-Up Care
Regular visits ensure stability of the canal and consistent IOP reduction.
Treatment Duration: 15–30 minutes per eye
Setting: Outpatient, same-day discharge
Recovery & After-Care
After-Care Guidelines
- Use anti-inflammatory drops for 2–4 weeks.
- Avoid eye rubbing or heavy exertion for several days.
- Expect mild hyphema—this is normal and temporary.
- Continue glaucoma medications only if instructed.
- Attend all scheduled follow-ups.
Recovery Timeline
- Days 1–3: Mild redness; hyphema begins resolving.
- Week 1: Noticeable IOP reduction; clearer vision.
- Weeks 2–4: Canal stabilizes; inflammation subsides.
- Months 1–3: Long-term pressure stabilization achieved.
Results & Longevity
Expected Results
- Significant IOP reduction, often comparable to traditional trabeculotomy.
- Reduced dependence on glaucoma medications.
- Better long-term optic nerve protection.
- High success in juvenile and secondary glaucomas.
Longevity
- Results often last 5–10+ years, depending on disease severity.
- Procedure can be repeated or combined with other MIGS if needed.
- Korean centers achieve high durability due to advanced imaging and precise catheter navigation.
Why Korea Is a Top Destination
- World-leading angle surgeons with extensive GATT expertise.
- High-resolution imaging systems for superior canal visualization.
- AI-driven planning for personalized pressure-lowering strategies.
- Minimal complication rates with rapid healing.
- Full-spectrum glaucoma care including diagnostics, surgery, and long-term follow-up.
Unique Korean Innovations
- AI-calibrated canalometry for customized catheter advancement.
- 3D gonioscopy with enhanced illumination for better visualization.
- Hybrid GATT + MIGS combinations for stronger IOP reduction.
- OCT-guided monitoring of canal patency.
- Predictive IOP modeling to forecast long-term success.
Cost Range (Indicative Estimate)
| Treatment Package | Price (KRW) | Approx. USD | Inclusions |
|---|---|---|---|
| Standard GATT | ₩2,000,000 – ₩3,200,000 | ~$1,500 – $2,400 | 360° trabeculotomy + routine imaging |
| Premium GATT With Angle Imaging | ₩3,500,000 – ₩4,800,000 | ~$2,600 – $3,600 | GATT + OCT-angle mapping + AI planning |
| Combined Cataract + GATT Surgery | ₩5,500,000 – ₩7,500,000+ | ~$4,100 – $5,600+ | Phaco + GATT + extended follow-up |
Popular Clinics in Korea
- B&VIIT Eye Center (Seoul) – Leaders in 360° GATT and canal-based surgery.
- Dream Eye Center (Seoul) – Experts in MIGS and angle procedures.
- BGN Eye Clinic (Busan & Seoul) – Specialists in combined cataract + GATT.
- Glory Seoul Eye Clinic – Advanced digital gonioscopy for precise GATT.
- K-Cure Vision Center (Gangnam) – AI-enhanced canal mapping and MIGS innovation.
