title: The rarity of clinically significant rise in intraocular pressure after laser peripheral iridotomy with apraclonidine.
abstract: OBJECTIVE
  To determine the incidence of intraocular pressure (IOP) rise of varying degrees after laser peripheral iridotomy (LPI) in patients with and without glaucoma treated perioperatively with pilocarpine and apraclonidine.
  
  
  METHODS
  A retrospective chart review.
  
  
  METHODS
  A total of 289 eyes in 179 patients with narrow occludable angles (NOA) (N = 148), open-angle glaucoma or ocular hypertension (OAG) (N = 115), or chronic-angle closure glaucoma (CACG) (N = 26) were reviewed.
  
  
  METHODS
  The difference between preoperative and postoperative IOP, absolute postoperative IOP, and the need for acute IOP-lowering treatment was noted.
  
  
  RESULTS
  Only 1.1% (95% confidence interval [CI], 0.03%-5.8%; 1 of 94) of patients and 0.7% (95% CI, 0.02%-3.7%; 1 of 148) of eyes with NOA experienced a rise of more than 10 mmHg 1 to 2 hours after LPI. The incidence of postoperative IOP greater than 25 mmHg and acute postoperative IOP-lowering management was 0% (95% CI, 0%-3.8%). Intraocular pressure in 1 of 115 eyes (0.9%, 95% CI, 0.02%-4.7%) with OAG rose more than 10 mmHg, requiring acute treatment. None of the 26 CACG eyes experienced a rise of more than 10 mmHg (95% CI, 0%-13.2%).
  
  
  CONCLUSIONS
  The IOP rise that requires further intervention after LPI with the perioperative use of pilocarpine and apraclonidine is very uncommon. In patients with NOA, routine postiridotomy IOP monitoring may not be required.
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison 53705, USA.
authors.forename: R
authors.initials: R
authors.lastname: Lewis
authors.forename: T W
authors.initials: TW
authors.lastname: Perkins
authors.forename: R
authors.initials: R
authors.lastname: Gangnon
authors.forename: P L
authors.initials: PL
authors.lastname: Kaufman
authors.forename: G A
authors.initials: GA
authors.lastname: Heatley
mesh_terms: D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D003000:Clonidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005901:Glaucoma / Q000188:drug therapy / Q000601:surgery*; D015812:Glaucoma, Angle-Closure / Q000188:drug therapy / Q000601:surgery; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D007498:Iris / Q000601:surgery*; D053685:Laser Therapy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000209:etiology / Q000517:prevention & control*; D009883:Ophthalmic Solutions; D010862:Pilocarpine / Q000008:administration & dosage / Q000627:therapeutic use; D012189:Retrospective Studies
chemical_list: D000316:Adrenergic alpha-Agonists; D009883:Ophthalmic Solutions; D010862:Pilocarpine; C016986:apraclonidine; D003000:Clonidine