To evaluate the effect of Gonioscopy-assisted transluminal trabeculotomy (GATT) on macular thickness and to compare the combined GATT and cataract extraction (CE) with GATT surgery alone regarding macular thickness.A retrospective, comparative study was designed. The patients who underwent GATT or combined GATT and CE with preoperative and regular postoperative spectral domain optic coherence tomography analysis (SD-OCT) were included. The macula was visualized in a 5 × 5 mmFifty-four eyes fulfilled the inclusion criteria and were enrolled in this study, (Group 1 = 29 eyes, Group 2 = 25 eyes). The mean thicknesses of central macula (CM), superior inner macula (SIM), and nasal inner macula (NIM) significantly increased 1 month after GATT alone (p 0.05). This difference became statistically insignificant at 3rd month after the surgery, (p 0.05). The mean thicknesses of SIM, temporal inner macula (TIM), NIM, superior outer macula (SOM), inferior outer macula (IOM), and temporal outer macula (TOM) showed a significant increase 1 month after combined GATT and CE, (p 0.05), which return its preoperative levels 3 months after the surgery (p 0.05). There was no significant difference between group 1 and group 2 with regard to change in macular thickness at each time points, (p 0.05). Postoperative clinically significant CME was observed in one patient who underwent GATT alone (p = 0.351).GATT can be a safe procedure with minimal and transient adverse effect on macular thickness and structure. Performing GATT together with CE caused no additional increase in the risk of macular thickening.