The study examined the efficacy and safety of two surgical methods—goniotomy (GT) and gonioscopy-assisted transluminal trabeculotomy (GATT)—in the treatment of exfoliation glaucoma, analyzing data from 14 studies involving 624 eyes. Both methods combined with cataract surgery (phacoemulsification) significantly reduced intraocular pressure by approximately 2 mmHg after 1, 6, and 12 months and reduced the need for antiglaucoma medications. Stand-alone goniotomy effectively reduced the number of medications at all follow-up periods and IOP at 1 and 6 months, while stand-alone GATT significantly reduced pressure only at 1 month. The most common complications were bleeding into the anterior chamber of the eye (47.6%) and temporary increase in intraocular pressure (17.0%). Both methods were found to be safe and effective, with their combination with cataracts providing more reliable long-term control of eye pressure.