Efficacy of brimonidine 0.2% in controlling acute postoperative intraocular pressure elevation after phacoemulsification.
To determine the efficacy of brimonidine tartrate 0.2% drops given 2 times a day in reducing intraocular pressure (IOP) spikes during the first 24 hours after phacoemulsification cataract surgery.



Department of Ophthalmology, General Hospital of Patras Agios Andreas, Patras, Greece.



In this prospective double-blind placebo-controlled study, 1 eye of 40 consecutive normotensive cataract patients having small-incision cataract surgery was randomized into 1 of 2 treatment arms. Twenty patients received a placebo (artificial tears) and 20 patients received brimonidine tartrate 0.2% drops 2 times a day the day before and the day of surgery. Diurnal IOP variation was the primary efficacy variable; IOP was measured at baseline, before surgery, and 4, 6, 12, and 24 hours postoperatively.



The placebo group had higher IOPs at every time point after surgery. Peak elevation of IOP occurred 6 hours after surgery. The mean IOP in the placebo group (27.71 mm Hg +/- 3.75 [SD]) was statistically significantly higher than in the brimonidine group (21.45 +/- 1.32 mm Hg) (P<.001). A major IOP rise (>/=20 mm Hg above baseline IOP) occurred in 1 patient (5%) in the placebo group who required emergency hypotensive therapy. Twenty-four hours after surgery, 11 eyes (55%) in the brimonidine group and 4 eyes (20%) in the placebo group had an IOP lower than baseline.



Prophylactic treatment with brimonidine tartrate 0.2% 2 times a day for 2 days was effective in reducing IOP peaks throughout the first 24 hours after phacoemulsification surgery.
Katsimpris
John M
JM
Department of Ophthalmology, General Hospital Agios Andreas, Alexandroupoli, Greece. jkatsimpris@yahoo.com
Siganos
Dimitrios
D
Konstas
Anastasios G P
AG
Kozobolis
Vassilios
V
Georgiadis
Nikolaos
N
D000208:Acute Disease; D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage*; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage; D000068438:Brimonidine Tartrate; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000517:prevention & control*; D009883:Ophthalmic Solutions; D018918:Phacoemulsification / Q000009:adverse effects*; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D011810:Quinoxalines / Q000008:administration & dosage*; D016896:Treatment Outcome
D000316:Adrenergic alpha-Agonists; D000959:Antihypertensive Agents; D009883:Ophthalmic Solutions; D011810:Quinoxalines; D000068438:Brimonidine Tartrate