Exfoliation syndrome is the most common identifiable cause leading to chronic open-angle glaucoma. It affects the treatment of glaucoma in various ways. The prognosis of capsular glaucoma (exfoliative glaucoma) is worse than that of open-angle glaucoma. Medical therapy and the long-term effect of laser treatment seem to be unsatisfactory in capsular glaucoma. Surgical intervention may be needed early, although eyes with exfoliation syndrome are prone to surgical complications. Finally, absolute glaucoma and blindness are more common in capsular glaucoma than in primary open-angle glaucoma. This article deals with the impact of exfoliation syndrome on therapeutic efficacy in open-angle glaucoma. It reviews the literature between October 1993 and September 1994; only a few studies concerning this important subject have been published during the given period.