The efficacy of brimonidine in decreasing elevations in intraocular pressure after laser trabeculoplasty.
OBJECTIVE
The authors explored the empirical dosing requirement for administration of an alpha 2-adrenoceptor agonist, brimonidine, and determined its efficacy in decreasing elevations in intraocular pressure (IOP) after 360 degrees argon laser trabeculoplasty (ALT).


METHODS
This vehicle-controlled, double-masked, multicenter trial evaluated three dosing regimens of brimonidine. Two hundred thirty-two patients for whom 360 degrees ALT was indicated were randomized into one of four treatment groups: 0.5% brimonidine both before and after ALT; brimonidine before but vehicle after ALT; vehicle before but brimonidine after ALT; or vehicle at both times.


RESULTS
During the first 3 hours after 360 degrees ALT, the overall incidence of IOP elevations of 5 mmHg or greater was 38% (23 of 60 eyes) in the group receiving vehicle only, and it ranged from 3% to 9% (2 of 62 to 5 of 53 eyes) in the groups receiving any brimonidine treatment. There was little difference in efficacy between the three dosing regimens of brimonidine. Brimonidine was well tolerated by the patients.


CONCLUSIONS
Based on this large, controlled, multicenter study, 0.5% brimonidine was an effective agent for reducing elevations in IOP after 360 degrees ALT. Only one dose, administered either before or after 360 degrees ALT, was required.
Barnebey
H S
HS
Department of Ophthalmology, University of Washington, Seattle.
Robin
A L
AL
Zimmerman
T J
TJ
Morrison
J C
JC
Hersh
S B
SB
Lewis
R A
RA
Coleman
A L
AL
Cinotti
D J
DJ
Walt
J
J
Chen
K S
KS
D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000068438:Brimonidine Tartrate; D004311:Double-Blind Method; D004361:Drug Tolerance; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D053685:Laser Therapy / Q000009:adverse effects*; D008875:Middle Aged; D009798:Ocular Hypertension / Q000209:etiology / Q000517:prevention & control*; D009883:Ophthalmic Solutions; D014677:Pharmaceutical Vehicles; D011810:Quinoxalines / Q000008:administration & dosage / Q000627:therapeutic use*; D014130:Trabeculectomy / Q000009:adverse effects*
D000316:Adrenergic alpha-Agonists; D009883:Ophthalmic Solutions; D014677:Pharmaceutical Vehicles; D011810:Quinoxalines; D000068438:Brimonidine Tartrate