Levobunolol 0.5% and timolol 0.5% to prevent intraocular pressure elevation after neodymium:YAG laser posterior capsulotomy.
OBJECTIVE
To evaluate the prophylactic effect of levobunolol 0.5%, timolol 0.5%, or vehicle in reducing the incidence of postoperative intraocular pressure (IOP) spikes of 5 and 10 mm Hg or more in patients having neodymium:YAG (Nd:YAG) laser posterior capsulotomy.


METHODS
Miami Vision Center, Coral Gables, Florida; Cullen Eye Institute, Baylor College of Medicine, Houston, Texas; Cincinnati Eye Institute, Cincinnati, Ohio; South Texas Cataract and Glaucoma Center, San Antonio, Texas; Mid-South Eye Foundation, Memphis, Tennessee, USA.


METHODS
This prospective, double-masked, randomized study comprised 144 patients having Nd:YAG laser posterior capsulotomy in one eye. One drop of the test medication was administered preoperatively and one drop on the evening after surgery; IOP was measured preoperatively and 1,2,3 and 24 hours postoperatively.


RESULTS
Intraocular pressure elevations of 5 mm Hg or more were seen in 1 of 60 patients (2%) in the levobunolol group, 4 of 54 (7%) in the timolol group, and 10 of 28 (36%) in the vehicle group. These elevations occurred significantly more frequently in the vehicle group than in the levobunolol (P < .001) or timolol (P < .004) groups. Elevations of 10 mm Hg or more were found in 2 of 28 patients (7%) treated with vehicle but were not observed in the patients treated with levobunolol or timolol.


CONCLUSIONS
Levobunolol 0.5% or timolol 0.5% administered preoperatively and again in the evening after Nd:YAG laser capsulotomy effectively blunted the IOP rise that frequently follows laser surgery.
Rakofsky
S
S
Allergan, Irvine, California 92623-9534, USA.
Koch
D D
DD
Faulkner
J D
JD
Terry
S A
SA
Mandell
A I
AI
Gross
R L
RL
Kelley
E P
EP
Iacono
T L
TL
Lue
J
J
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000473:pathology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D053685:Laser Therapy / Q000009:adverse effects*; D007903:Lens Capsule, Crystalline / Q000473:pathology / Q000601:surgery*; D002040:Levobunolol / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000209:etiology / Q000517:prevention & control*; D009883:Ophthalmic Solutions; D011292:Premedication; D011446:Prospective Studies; D013999:Timolol / Q000008:administration & dosage*
D000319:Adrenergic beta-Antagonists; D009883:Ophthalmic Solutions; D013999:Timolol; D002040:Levobunolol