Effect of prophylactic brimonidine on bleeding complications after cataract surgery.
OBJECTIVE
To evaluate the effect of prophylactic brimonidine on bleeding complications after cataract surgery.


METHODS
The authors performed a prospective, double-masked, two-surgeon study of 137 patients (137 eyes) who underwent phacoemulsification and intraocular lens implantation with or without prophylactic brimonidine before cataract surgery. The authors also compared the effect of brimonidine among patients with systemic diseases such as diabetes mellitus (types I and II), hypertension, and anticoagulant or antiplatelet treatment.


RESULTS
Subconjunctival hemorrhage was observed in 73.70% of the patients not treated with brimonidine before surgery and in only 23.75% of the patients who were given prophylactic brimonidine (p<0.001, chi2). The grade of hemorrhage was also statistically significant (p<0.001, Mann-Whitney). No statistically significant difference with regard to the presence of hemorrhage in diabetic patients or in the anticoagulant or antiplatelet treatment group was observed. However, a statistically significant difference (p<0.027, chi2) was found between hypertensive patients treated and not treated with prophylactic brimonidine before cataract surgery.


CONCLUSIONS
This study suggests that brimonidine administered before cataract surgery may significantly reduce subconjunctival hemorrhage in the general population. It has been shown to be beneficial in hypertensive patients. A strong statistical trend, but not significance has been found in diabetic patients or in patients treated with antiplatelet or anticoagulant drugs, but further studies are needed to reach conclusive results.
Desco
M C
MC
Service of Ophthalmology, La Fe University Hospital, Valencia--Spain. carmen.desco@uv.es
Navea
A
A
Ferrer
E
E
Menezo
J L
JL
D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000068438:Brimonidine Tartrate; D015897:Comorbidity; D003229:Conjunctival Diseases / Q000517:prevention & control*; D004311:Double-Blind Method; D005130:Eye Hemorrhage / Q000517:prevention & control*; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications; D011446:Prospective Studies; D011810:Quinoxalines / Q000627:therapeutic use*
D000316:Adrenergic alpha-Agonists; D011810:Quinoxalines; D000068438:Brimonidine Tartrate