Revue de la Littérature Traitement actuel du glaucome pseudo-exfoliatif et options thérapeutiques

Abstract

Pseudoexfoliation glaucoma (PXFG) is known as the most common secondary open angle glaucoma. Accumulation of exfoliative debris in the angle and subsequent IOP elevations is thought to help make PXFG more recalcitrant to topical/medical therapy than primary open angle glaucoma. Laser therapy treatment in the form of selective laser trabeculoplasty for open angle PXFG is therefore discussed. Attention is also called however to the risk of an angle closure component in PXFG eyes and several possible mechanisms behind this. A literature-based discussion on the risks and benefits of laser peripheral iridotomy or cataract surgery to open the angle follows. Literature on the many microinvasive glaucoma surgery options (MIGS) available for PXFG is also reviewed. We provide an overview of MIGS subtypes and summarize study data on several of the better studied options for PXFG. The efficacy and risks of filtering procedures including trabeculectomy and tube shunts for PXFG is also examined.