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Management of exfoliative glaucoma: challenges and solutions

Authors Hollo G, Katsanos A, Konstas A

Received 17 March 2015

Accepted for publication 14 April 2015

Published 22 May 2015 Volume 2015:9 Pages 907—919


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Dr Scott Fraser

Gábor Holló,1 Andreas Katsanos,2 Anastasios GP Konstas3

1Department of Ophthalmology, Semmelweis University, Budapest, Hungary; 2Department of Ophthalmology, University of Ioannina, Ioannina, 3First and Third Departments of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece

Abstract: Exfoliative glaucoma is the most common type of secondary open-angle glaucoma worldwide. It is characterized by high intraocular pressure (IOP) and worse 24-hour IOP characteristics. In order to minimize progression, treatment of exfoliative glaucoma has to provide a low long-term mean IOP and good 24-hour IOP control. To achieve these goals, fixed-dose combination eye drops, argon and selective laser trabeculoplasty, and various forms of surgery (trabeculectomy, deep sclerectomy, viscocanalostomy, ab interno trabeculotomy, trabecular aspiration, and cataract surgery) all need to be considered during the long-term management of the disease. Since exfoliative glaucoma is a disease of the elderly, and is frequently associated with systemic vascular disease, interdisciplinary consultations are of great clinical importance. These management aspects and the current medical, laser, and surgical results are covered in this review, with a special focus on the needs of the general ophthalmologist.

Keywords: exfoliative glaucoma, pseudoexfoliative glaucoma, medication, laser trabeculoplasty, deep sclerectomy, viscocanalostomy, trabeculectomy

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