Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, AB, Canada.
J Glaucoma. 2018 Jul;27 Suppl 1:S91-S94. doi: 10.1097/IJG.0000000000000909.
Argon laser trabeculoplasty as well as selective laser trabeculoplasty can be used in patients with exfoliation syndrome with similar safety and efficacy. However, treatment effect may abruptly reverse and patients need to be followed regularly to monitor intraocular pressure control. Newer laser treatment modalities including micropulse laser trabeculoplasty, titanium sapphire laser trabeculoplasty and pattern scanning trabeculoplasty show promising results but need to be studied in exfoliation patients. For exfoliation patients with angle closure, peripheral iridectomy, iridoplasty or cataract extraction can be very helpful. For refractory exfoliation glaucoma, transscleral diode laser cyclophotocoagulation offers a reasonable option to lower intraocular pressure. Other approaches to cyclophotocoagulation such as micropulse transcleral diode laser need to be studied further in exfoliation patients.
氩激光小梁成形术和选择性激光小梁成形术可用于伴有剥脱综合征的患者，具有相似的安全性和疗效。然而，治疗效果可能会突然逆转，患者需要定期随访以监测眼压控制。包括微脉冲激光小梁成形术、钛宝石激光小梁成形术和模式扫描小梁成形术在内的新型激光治疗方法显示出良好的效果，但需要在剥脱患者中进行研究。对于闭角型剥脱患者，周边虹膜切除术、虹膜成形术或白内障摘除术非常有帮助。对于难治性剥脱性青光眼，经巩膜二极管激光睫状体光凝术是降低眼压的合理选择。其他睫状体光凝术方法，如微脉冲经巩膜二极管激光，需要在剥脱患者中进一步研究。
