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37 EW GLAUCOMA December 2018 Contact information Lazreg: slazbkt@yahoo.fr alone or in combination with cat- aract extraction, by clearing away trabecular debris and pigment and reestablishing physiological outflow. The effect tends to regress 2–4 years after surgery, however, most likely because of a reaccumulation of exfo- liation material over time. Another option, Trabectome (NeoMedix, Tustin, California) mediated ab interno trabeculectomy, showed promise in PXF patients in a recent study that analyzed Trabec- tome versus phaco-Trabectome out- comes by glaucoma severity. 7 Also, viscocanalostomy, a technique that aims to facilitate aqueous flow with- out completely penetrating the eye, is effective in PXF in reducing IOP when it is combined with cataract surgery, according to Dr. Lazreg. "Inflammation has been implicated in the development of PXF, and therefore, after surgery, the presence of an increased ocular inflammatory response should be taken into consideration. Also, IOP should be monitored closely and IOP prophylaxis considered in the immediate postoperative period. Ear- ly postoperative IOP spikes are more common in PXF eyes, particularly in those with PXFG," she said. EW References 1.Wang W, et al. Selective laser trabecu- loplasty versus argon laser trabeculoplasty in patients with open-angle glaucoma: a systematic review and meta-analysis. PLoS One. 2013;8:e84270. 2. Polat J, at al. Repeatability of selective laser trabeculoplasty. Br J Ophthalmol. 2016; 100:1437–41. 3. Kornmann HL, Gedde SJ. Surgical man- agement of pseudoexfoliation glaucoma. Int Ophthalmol Clin. 2014;54:71–83. 4. McAlinden C. Selective laser trabeculoplasty (SLT) vs other treatment modalities for glau- coma: systematic review. Eye (Lond). 2014; 28:249–58. 5. Jimenez-Roman J, et al. Effect of phacoemulsification on intraocular pressure in patients with primary open angle glauco- ma and pseudoexfoliation glaucoma. Int J Ophthalmol. 2017;10:1374–1378. 6. Moisseiev E, et al. Standard trabeculectomy and Ex-PRESS miniature glaucoma shunt: a comparative study and literature review. J Glaucoma. 2015;24:410–6. 7. Dang Y, et al. Combined analysis of trabectome and phaco-trabectome outcomes by glaucoma severity. Version 2. F1000Res. 2016;5:762. Editors' note: Dr. Lazreg has no finan- cial interests related to her comments. Are you a fan of EyeWorld? Like us on Facebook facebook.com/ EyeWorldMagazine

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