Effects of atropine on anterior chamber depth and anterior chamber inflammation after primary trabeculectomy.
OBJECTIVE
To investigate the effects of postoperative atropine on central and peripheral anterior chamber depth and anterior chamber inflammation in patients undergoing primary trabeculectomy.


METHODS
Two separate groups of patients who were phakic without previous intraocular surgery undergoing primary trabeculectomy were prospectively randomized to atropine or no atropine. In the first group of patients, 24 eyes of 21 patients undergoing primary trabeculectomy were prospectively randomized to atropine or no atropine, and their anterior chamber depth was measured. Central and peripheral chamber depths were measured using the EAS-1000 anterior segment analysis system (Nidek, Tokyo, Japan) before surgery and on postoperative days 1, 3, 7, 14, and 30. In the second group, 34 patients undergoing primary trabeculectomy were prospectively randomized to atropine or no atropine, and their anterior chamber reaction was documented. The amount of cells and flare was measured using the Kowa laser flare meter (FM-500) and cell counter (LC-500) (Kowa Electronics and Optics, Tokyo, Japan) preoperatively and on postoperative day 1, 7, and 30.


RESULTS
Compared with preoperative measurements, a small (approximately 0.1 mm) but statistically significant deepening of the central and peripheral anterior chamber depth on days 1, 7, 14, and 30 was found in patients who used atropine. In the nonatropine group, no statistically significant change was found in central or peripheral anterior chamber depths at any time as compared with preoperative values. There was no statistically significant difference in the cell or flare counts between the atropine and nonatropine groups at any time.


CONCLUSIONS
This study showed a small but statistically significant deepening of the anterior chamber with atropine. No statistically significant differences were observed in the cell or flare counts between atropine and nonatropine groups. Routine atropine use after trabeculectomy may not be necessary to reduce postoperative complications, such as shallowing of the anterior chamber or anterior chamber inflammation. In patients with a shallow anterior chamber, however, atropine would be expected to deepen the chamber.
Orengo-Nania
S
S
Cullen Eye Institute, Baylor College of Medicine, Houston 77030, USA.
El-Harazi
S M
SM
Oram
O
O
Feldman
R M
RM
Chuang
A Z
AZ
Gross
R L
RL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000187:drug effects* / Q000473:pathology; D001285:Atropine / Q000008:administration & dosage / Q000627:therapeutic use*; D002452:Cell Count; D005260:Female; D005902:Glaucoma, Open-Angle / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009184:Mydriatics / Q000008:administration & dosage / Q000627:therapeutic use*; D009883:Ophthalmic Solutions; D011379:Prognosis; D011446:Prospective Studies; D014130:Trabeculectomy / Q000009:adverse effects*; D014606:Uveitis, Anterior / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D014792:Visual Acuity
D009184:Mydriatics; D009883:Ophthalmic Solutions; D001285:Atropine