Take steps to manage pseudoexfoliation glaucoma in cataract surgery
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WAIKOLOA, Hawaii — Keep the cornea in mind and protect the endothelium when managing pseudoexfoliation glaucoma during cataract surgery, a presenter said here.
“Consider femto if at all possible to decrease the ultrasound and combine with angle surgery, but skip the implants to save the cornea,” Malik Y. Kahook, MD, said at Hawaiian Eye 2022.
The second key is to target the angle first and early.
“Pseudoexfoliation does not stop — play the long game,” he said.
In addition, skip endocyclophotocoagulation because it usually does not work.
Kahook said that he prefers to use the Streamline surgical system (New World Medical) when treating mild pseudoexfoliation glaucoma because it addresses multiple targets for lowering IOP.
The system can also open the trabecular meshwork for precision goniotomies. Once the inner cannula is inside of the canal, Kahook said, it can dilate the canal, stretch the trabecular meshwork and flush the collector channels.
“No implant is left behind,” Kahook said. “You can do this standalone or with cataract surgery.”
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Kahook MY. Pseudoexfoliation: Managing co-existing glaucoma. Presented at: Hawaiian Eye 2022; Jan. 15-21, 2022; Waikoloa, Hawaii.
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