97th DOG Annual Meeting 1999
LOCAL APPLICATION OF 0.2% BRIMONIDINE TARTRATE FOR PREVENTION OF INCREASED INTRAOCULAR PRESSURE AFTER ND: YAG CAPSULOTOMY FOR POSTERIOR CAPSULE OPACIFICATION
E. Simader, B. Wannke, M. Derse, M. Knorr, H.-J. Thiel
We asked whether 0.2% brimonidine tartrate can be used as a safe and effective alternative to acetazolamide to prevent post-laser IOP rise.
Methods: We performed Nd: YAG capsulotomy for PCO in 32 patients (mean age: 65.7 years). Only one eye of each patient was included into the study. Group I consisted of 27 patients: ten minutes prior to YAG capsulotomy a single drop of 0.2% brimonidine tartrate was applied. Group II included 5 patients receiving acetacolamid 500mg p.o. and potassium ten minutes prior to laser treatment. IOP was measured before application of any drops or tabletts (T0) and one hour (T1), six hours (T2), and 24 hours (T3) after laser treatment. Statistic analysis included Student´s t-test.
Results: Group I: Mean IOP of patients, receiving brimonidine tartrate, was 13.11 ± 2.81 mmHg at T0, 13.28 ± 3.27 mmHg (p=0.44) at T1, 12.68 ± 2.51 mmHg (p=0.30) at T2, and 12.59 ± 2.36 mmHg (p=0.14) at T3. Maximum increase of IOP was 6 mmHg (T0 to T1), 9 mmHg (T0 to T2) and 5 mmHg (T0 to T3). Compared with pre-laser IOP no significant rise of mean IOP after prophylaxis with brimonidine tartrate was observed. No ocular or systemic side effects appeared. Group II: Mean IOP was 14.40 2.30 mmHg at T0, 12.40 1.52 mmHg (p=0.09) at T1, 12.80 2.05 mmHg (p=0.08) at T2 and 12.80 1.92 mmHg (p=0.19) at T3. In group II maximum increase of IOP was 1 mmHg (T0 to T1), 1mmHg (T0 to T2) and 2 mmHg (T0 to T3). No significant rise of mean IOP compared with pre-laser data was observed in group II as well. One of the five patients complained about dizziness and nausea after acetacolamide and potassium; all patients complained about the bad taste of potassium.
Conclusion: The results of our pilot study suggest that a single drop of 0.2% brimonidine tartrate is an effective and safe alternative to acetazolamide in the prevention of intraocular pressure elevation after Nd: YAG capsulotomy.
University Eye Clinic, Dep. I: General Ophthalmology, Schleichstr. 12, D-72076 Tuebingen