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WGA Rescources

Abstract #6461 Published in IGR 3-2

Brimonidine 0.2% versus apraclonidine 0.5% for prevention of intraocular pressure elevations after anterior segment laser surgery

Chen TC; Ang RT; Grosskreutz CL; Pasquale LR; Fan JT
Ophthalmology 2001; 108: 1033-1038


OBJECTIVE: To compare the efficacy of brimonidine 0.2% with apraclonidine 0.5% in preventing intraocular pressure (IOP) elevations after anterior segment laser surgery. DESIGN: A double-masked, randomized clinical trial. PARTICIPANTS: Sixty-six patients underwent either laser peripheral iridotomy, argon laser trabeculoplasty, or Nd:YAG laser capsulotomy. INTERVENTION: Eyes received either one drop of brimonidine 0.2% or apraclonidine 0.5% before laser surgery. MAIN OUTCOME MEASURES: IOP, heart rate, and blood pressure were measured before laser surgery and at one, three, and 24 hours and one week after laser surgery. RESULTS: Before the laser treatment, 33 patients (50.0%) received brimonidine 0.2%, and 33 patients (50.0%) received apraclonidine 0.5%. Eight of 33 patients (24.2%) in the brimonidine-treated group and nine of 33 patients (27.3%) in the apraclonidine group had postoperative IOP increased of 5 mmHg or more. This was not statistically different (p = 0.80). By the time of the last follow-up examination, three of 33 patients (9.1%) in the brimonidine-treated group and three of 33 (9.1%) in the apraclonidine group had IOP increases of 10 mmHg or more. This was also not statistically different (p 0.95). The mean IOP reduction from baseline in the brimonidine group (-2.8 ± 2.8 mmHg) was not statistically different (p = 0.55) compared with that in the apraclonidine group (-3.6 ± 3.3 mmHg). There were no statistically significant changes in mean heart rate or blood pressure in either group, except for a slight reduction in diastolic blood pressure at one hour (p = 0.005) in the brimonidine group (-5.2 ± 7.4 mmHg) compared with the apraclonidine group (-0.2 ± 6.4 mmHg). There were no clinically significant side-effects noted in either group. CONCLUSIONS: A single preoperative drop of brimonidine 0.2% is as effective as apraclonidine 0.5% in preventing IOP elevation immediately after anterior segment laser surgery.

Dr T.C. Chen, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, USA. teresa_chen@meei.harvard.edu


Classification:

11.3.3 Apraclonidine, brimonidine (Part of: 11 Medical treatment > 11.3 Adrenergic drugs)
12.2 Laser iridotomy (Part of: 12 Surgical treatment)
12.4 Laser trabeculoplasty and other laser treatment of the angle (Part of: 12 Surgical treatment)



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