[Prevention of early postoperative increase in intraocular pressure after phacoemulsification. Comparison of different antiglaucoma drugs].
OBJECTIVE
To compare the ocular hypotensive effect of different antiglaucomatous eye drops.


METHODS
This double-blind, randomized study included 119 eyes of 119 patients without other ocular pathology undergoing standardized (one surgeon, Healon) small incision cataract surgery with foldable intraocular lens implantation. The patients were assigned to one of five groups: group 1: 0.25% timolol in Gelrite (extended efficacy, n = 23); group 2: 2% dorzolamide (n = 24); group 3: combination of 0.5% timolol plus 2% dorzolamide (n = 22); group 4: brimonidine (n = 26); group 5: gentamicin (control, n = 24). Intraocular pressure (IOP) was measured preoperatively and at 3 +/- 1, 6 +/- 1, 9 +/- 1, 24 +/- 3, and 48 +/- 3 h postoperatively. Statistical interference was determined by nonparametric group comparisons using Wilcoxon's tests. Absolute values (static comparison) and intraindividual differences from preoperative measurements (dynamic comparisons) were evaluated. All p values should be regarded as descriptive values since they were not formally adjusted for multiplicity. A p value lower than 0.05 therefore indicates local statistical significance.


RESULTS
There were no differences between the groups with regard to age, phacoemulsification time, axial length, and preoperative IOP. A statistically significant IOP decrease was measured in group 1 at 24 (p = 0.028) and 48 h (p = 0.007) and in group 3 at 3 (p = 0.001), 6 (p = 0.001), 24 (p = 0.001), and 48 h (p = 0.001) after surgery. A statistically significant IOP increase occurred in group 4 at 3 (p = 0.001), 6 (p = 0.001), and 9 h (p = 0.001) and in group 5 at 3 (p = 0.001), 6 (p = 0.001), 9 (p = 0.001), and 24 h (p = 0.002) postoperatively. Groups 1, 2, and 3 demonstrated lower IOPs at different time points in comparison to groups 4 and 5. Furthermore, group 3 had lower IOPs at 3 h (compared to group 1) and at 6 h (compared to group 2) postoperatively. No statistical differences in IOP were found after 48 h.


CONCLUSIONS
The results favor a combination of 0.5% timolol plus 2% dorzolamide to control postoperative IOP elevation.
Schwenn
O
O
Universitäts-Augenklinik Mainz, Langenbeckstrasse 1, 55131 Mainz.
Xia
N
N
Krummenauer
F
F
Dick
H B
HB
D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage / Q000494:pharmacology; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000494:pharmacology; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000494:pharmacology; D000068438:Brimonidine Tartrate; D002257:Carbonic Anhydrase Inhibitors / Q000008:administration & dosage / Q000494:pharmacology; D003627:Data Interpretation, Statistical; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D019654:Lens Implantation, Intraocular; D008875:Middle Aged; D009883:Ophthalmic Solutions; D018918:Phacoemulsification; D011135:Polysaccharides, Bacterial; D011182:Postoperative Care; D011183:Postoperative Complications / Q000517:prevention & control*; D011810:Quinoxalines / Q000008:administration & dosage / Q000494:pharmacology; D013449:Sulfonamides / Q000008:administration & dosage / Q000494:pharmacology; D013876:Thiophenes / Q000008:administration & dosage / Q000494:pharmacology; D013997:Time Factors; D013999:Timolol / Q000008:administration & dosage / Q000494:pharmacology
D000316:Adrenergic alpha-Agonists; D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D002257:Carbonic Anhydrase Inhibitors; D009883:Ophthalmic Solutions; D011135:Polysaccharides, Bacterial; D011810:Quinoxalines; D013449:Sulfonamides; D013876:Thiophenes; D000068438:Brimonidine Tartrate; C048288:gellan gum; D013999:Timolol; C062765:dorzolamide