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M.P. Rubin, E.K. Chiu, S. Rao; Comparison of Brimonidine Tartrate 0.15% and Acetazolamide in Controlling Acute Postoperative Intraocular Pressure Elevation After Phacoemulsification . Invest. Ophthalmol. Vis. Sci. 2005;46(13):788.
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Purpose: To compare the efficacy of topical brimonidine tartrate 0.15% versus oral acetazolamide given postoperatively in reducing intraocular pressure (IOP) spikes during the first 24 hours after phacoemulsification cataract surgery Methods: 83 eyes of 83 consecutive patients undergoing small–incision cataract surgery were randomized into 1 of 3 treatment arms. Eyes with glaucoma were exluded from the study. 35 patients received no treatment, 27 patients received brimonidine tartrate 0.15% one drop immediately after surgery, and 21 patients received one dose of acetazolamide 500mg oral treatment immediately after surgery. Postoperative IOP spike was defined as a pressure increase of 10 mmHg or more from the preoperative IOP. Results: The control group had an average increase in IOP of 5.94 ± 8.74 mmHg, with 10/35 patients (29%) experiencing a postoperative pressure spike. The brimonidine tartrate 0.15% group had an average increase in IOP of 3.96 ± 7.31 mmHg, with 4/27 patients (14.8%) experiencing a postoperative pressure spike. The oral acetazolamide group had an average increase in IOP of 1.47 ± 6.13 mmHg, with 3/21 patients (14.3%) experiencing a postoperative pressure spike. There were no clinically significant side effects noted in all three groups. Conclusions: There was no significant difference between prophylactic treatment with brimonidine tartrate 0.15% and acetazolamide in preventing postoperative IOP spikes (p=0.8). Both treatments were significantly more effective than no perioperative treatment (p<0.05). These results suggest that brimonidine tartrate 0.15% may be given after cataract surgery, as a single dose agent, to prevent postoperative pressure spikes.
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