Abstract
Purpose:
Preoperative and immediate postoperative treatment with an alpha 2 stimulant, apraclonidine, reduces the early post-surgical increases in the blood-aqueous barrier permeability and intraocular pressure (IOP) in eyes after successful cataract surgery. We herein evaluated the effects of another topical alpha 2 stimulant, brimonidine, on the early postoperative IOP and blood-aqueous barrier permeability in subject with glaucoma after cataract surgery.
Methods:
We conducted a prospective randomized clinical trial in which 37 patients undergoing uncomplicated phacoemulsification and posterior chamber intraocular lens implantation were randomly assigned to treatment with 0.1% brimonidine or control. One drop of 0.1% brimonidine was instilled 1/2 hour preoperatively and immediately postoperatively. The IOP and aqueous flare intensity were determined before the operation and six hours, 24 hours and seven days after the operation using a Goldmann applanation tonometer and a laser flare-cell meter. The IOP just after surgery was adjusted between 10-15 mmHg using a Tono-Pen with sterilized film. Anti- glaucoma eye drops were used without cessation. All procedures adhered to the tenets of the Declaration of Helsinki, and their use was approved by the Institutional Review Board of Hiroshima University, Japan.
Results:
Eighteen eyes were assigned to the brimonidine group and 19 eyes to the control group. An IOP increase was observed six hours postoperatively in both groups. The IOP in the control group (19.2±4.0 mmHg) was significantly higher than that in the brimonidine group (15.8±4.9 mmHg, P=0.034). The aqueous flare intensity was highest six hours after surgery. There were no significant differences between the two groups.
Conclusions:
Although the topical application of brimonidine before and after cataract surgery successfully prevented the IOP elevation in glaucoma subjects, brimonidine could not suppress the flare intensity increase.
Keywords: 568 intraocular pressure •
557 inflammation •
445 cataract