Effect of intracameral acetylcholine on latanoprost in preventing ocular hypertension after phacoemulsification and intraocular lens implantation.
OBJECTIVE
To evaluate the effect of intracameral acetylcholine on latanoprost in preventing ocular hypertension in the early period after phacoemulsification with posterior chamber intraocular lens (PC IOL) implantation.


METHODS
Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Shatin, Hong Kong, China.


METHODS
Patients with uncomplicated cataract having phacoemulsification with PC IOL implantation were included in this prospective randomized double-masked clinical trial. The eyes were randomly assigned to 1 of 4 groups based on postoperative application of latanoprost 0.005% alone (Group 1), latanoprost 0.005% with intracameral acetylcholine (Group 2), intracameral acetylcholine alone (Group 3), and no medication (controls (Group 4). Intraocular pressure (IOP) was measured 3 and 24 hours postoperatively. The anterior chamber was examined for the level of cells and flare using slitlamp biomicroscopy.


RESULTS
Three and 24 hours after surgery, the decrease in mean IOP in eyes receiving latanoprost alone was not statistically significantly different from that in control eyes (P >.05). Eyes receiving intracameral acetylcholine alone had a significant decrease in the mean IOP at 3 hours (P <.05) but not at 24 hours compared to control eyes (P >.05). There were no significant differences in the mean postoperative IOP decrease between eyes receiving latanoprost with intracameral acetylcholine and those receiving intracameral acetylcholine alone (P >.05).


CONCLUSIONS
A single application of latanoprost did not significantly lower IOP in the first 24 hours after phacoemulsification with PC IOL implantation. Eyes receiving intracameral acetylcholine alone had a significantly greater decrease in IOP than control eyes at 3 hours but not at 24 hours. The addition of intracameral acetylcholine to latanoprost did not enhance or reduce latanoprost's IOP-lowering effect.
Lai
J S
JS
Department of Ophthalmology, United Christian Hospital, Kowloon, Hong Kong, China. jsmlai@netvigator.com
Chua
J K
JK
Loo
A
A
Ho
S Y
SY
Lam
D S
DS
D000109:Acetylcholine / Q000008:administration & dosage / Q000627:therapeutic use*; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D000077338:Latanoprost; D019654:Lens Implantation, Intraocular / Q000009:adverse effects*; D008297:Male; D009798:Ocular Hypertension / Q000209:etiology / Q000517:prevention & control*; D009883:Ophthalmic Solutions; D018918:Phacoemulsification / Q000009:adverse effects*; D011446:Prospective Studies; D011461:Prostaglandins F, Synthetic / Q000008:administration & dosage / Q000627:therapeutic use*
D000959:Antihypertensive Agents; D009883:Ophthalmic Solutions; D011461:Prostaglandins F, Synthetic; D000077338:Latanoprost; D000109:Acetylcholine