Topical 2.0% dorzolamide vs oral acetazolamide for prevention of intraocular pressure rise after neodymium:YAG laser posterior capsulotomy.
OBJECTIVE
To compare the efficacy and safety of topical 2.0% dorzolamide hydrochloride with oral acetazolamide in preventing intraocular pressure (IOP) rise following neodymium:YAG (Nd:YAG) laser posterior capsulotomy.


METHODS
A prospective, randomized, double-masked, placebo-controlled study.


METHODS
Two hundred ten patients undergoing Nd:YAG laser posterior capsulotomy.


METHODS
Pretreatment with dorzolamide, acetazolamide, or placebo. Dorzolamide administration as a single drop (1 drop approximately 20 microL) 1 hour before capsulotomy. Acetazolamide administration as a single dose of 125 mg orally 1 hour before capsulotomy.


RESULTS
At first and third hour postoperatively, IOPs and IOP changes from baseline were significantly (P<.001) higher in the placebo group than in the dorzolamide or acetazolamide group. At the same time, IOPs and IOP changes from baseline were similar (P>.50) in the dorzolamide and acetazolamide groups. No patient treated with dorzolamide or acetazolamide experienced an IOP higher than 30 mm Hg after capsulotomy, but 15.7% of patients receiving placebo had an IOP above this level (P<.001). Of patients receiving placebo, 5.7% experienced IOP higher than 35 mm Hg. No serious side effects were recorded in any of the studied patients.


CONCLUSIONS
Topical 2.0% dorzolamide and oral acetazolamide, given prophylactically as a single administration 1 hour before Nd:YAG laser posterior capsulotomy, have comparable high efficacy and safety in preventing IOP elevation following this procedure.
Ladas
I D
ID
Department of Ophthalmology, Athens University School of Medicine, Greece.
Baltatzis
S
S
Panagiotidis
D
D
Zafirakis
P
P
Kokolakis
S N
SN
Theodossiadis
G P
GP
D000086:Acetazolamide / Q000008:administration & dosage* / Q000627:therapeutic use; D000284:Administration, Oral; D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D002257:Carbonic Anhydrase Inhibitors / Q000008:administration & dosage* / Q000627:therapeutic use; D002387:Cataract Extraction; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D053685:Laser Therapy / Q000009:adverse effects* / Q000379:methods; D007903:Lens Capsule, Crystalline / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000209:etiology / Q000517:prevention & control; D009883:Ophthalmic Solutions; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D012449:Safety; D013449:Sulfonamides / Q000008:administration & dosage* / Q000627:therapeutic use; D013876:Thiophenes / Q000008:administration & dosage* / Q000627:therapeutic use; D016896:Treatment Outcome
D002257:Carbonic Anhydrase Inhibitors; D009883:Ophthalmic Solutions; D013449:Sulfonamides; D013876:Thiophenes; C062765:dorzolamide; D000086:Acetazolamide