Response of exfoliation glaucoma to laser trabeculoplasty

The comparative response of exfoliation (EF) glaucoma and primary open-angle glaucoma (POAG) to laser trabeculoplasty (LTP) was studied retrospectively. The effectiveness of argon laser trabeculoplasty (LTP) was compared in 26 eyes of patients with EF glaucoma (uncontrollable by maximally tolerated medical therapy) and 28 eyes of patients with POAG (controls). 64% of the POAG group and 46% of the EF glaucoma group received treatment of the entire angle in two divided sessions in order to reduce the intraocular pressure (IOP) to less than or equal to 22 mmHg. All second treatments were performed at least four to six weeks after the initial session. Evaluation of the postoperative course of IOP by means of the Kaplan-Meier curve for data analysis indicated that EF patients 'failed' at a faster rate than POAG patients after both the initial and consecutive laser treatments. The rate of failure in the EF group, however, was greater following the initial 180 degrees treatment. Although patients with EF glaucoma have a large initial reduction in intraocular pressure after LTP, to increase the probability of maintaining intraocular pressures of less than or equal to 22 mmHg consecutive 180 degrees treatments should be considered.