Brimonidine in the prevention of intraocular pressure elevation following argon laser trabeculoplasty.
OBJECTIVE
To evaluate the efficacy of 0.5% brimonidine tartrate, an alpha 2-adrenergic agonist, in preventing intraocular pressure (IOP) elevation following argon laser trabeculoplasty.


METHODS
In a multicenter, double-masked, randomized study, 248 patients (248 eyes) who underwent argon laser trabeculoplasty were allocated to four treatment groups: (1) brimonidine administered before and after the procedure; (2) brimonidine administered before the procedure; (3) brimonidine administered after the procedure; and (4) a vehicle administered before and after the procedure.


RESULTS
In the first 3 hours after argon laser trabeculoplasty, only one (0.54%) of the 183 brimonidine-treated patients had a postlaser IOP increase of 10 mm Hg or more, while increases of this magnitude occurred in 13 (23%) of the 56 patients who received only the vehicle (P < .001). The three brimonidine-treatment groups demonstrated significant mean reductions in IOP from the pretrabeculoplasty level (-4 to -8 mm Hg), whereas the vehicle-treated group showed an increase in mean IOP (4 mm Hg). Side effects associated with brimonidine treatment included conjunctival blanching (40.9%), lid retraction (7.6%), and a slight lowering of the systolic blood pressure.


CONCLUSIONS
One drop of 0.5% brimonidine administered either before or after surgery was found to be efficacious and safe in preventing posttrabeculoplasty elevations in IOP.
David
R
R
Department of Ophthalmology, Soroka University Hospital, Beer-Sheva, Israel.
Spaeth
G L
GL
Clevenger
C E
CE
Perell
H F
HF
Siegel
L I
LI
Henry
J C
JC
Stiles
M C
MC
Passo
M S
MS
Stamper
R L
RL
Walt
J G
JG
D000316:Adrenergic alpha-Agonists / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000068438:Brimonidine Tartrate; D004311:Double-Blind Method; D005901:Glaucoma / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D053685:Laser Therapy / Q000009:adverse effects; D009798:Ocular Hypertension / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D009883:Ophthalmic Solutions; D011810:Quinoxalines / Q000009:adverse effects / Q000627:therapeutic use*; D014130:Trabeculectomy / Q000009:adverse effects*
D000316:Adrenergic alpha-Agonists; D000959:Antihypertensive Agents; D009883:Ophthalmic Solutions; D011810:Quinoxalines; D000068438:Brimonidine Tartrate