Medical control of intraocular pressure after phacoemulsification.
OBJECTIVE
To compare the effectiveness of oral acetazolamide, topical brinzolamide 1%, and no ocular hypotensive medication after phacoemulsification.


METHODS
Adnan Menderes University Department of Ophthalmology, Aydin, Turkey.


METHODS
This prospective randomized double-blind study comprised 60 eyes of 52 patients having phacoemulsification under topical anesthesia. There were no intraoperative complications. Eyes were randomized to receive oral acetazolamide 500 mg 1 hour preoperatively followed by 250 mg acetazolamide every 6 hours, 1 drop of brinzolamide 1% every 12 hours starting immediately after speculum removal, or no ocular hypotensive medication. Intraocular pressure (IOP) was measured using a Perkins tonometer preoperatively and 4 to 6 hours and 18 to 24 hours postoperatively.


RESULTS
The preoperative IOP was not significantly different between the 3 groups. Four to 6 hours postoperatively, the acetazolamide group (P=.002) and brinzolamide group (P=.001) had significantly lower IOP than the control group. The same trend was observed at 18 to 24 hours in the brinzolamide group (P=.001) but not the acetazolamide group (P=.018). The IOP levels were not significantly different between the acetazolamide group and brinzolamide group at any postoperative time point. No eye receiving medication and 2 eyes (10%) in the control group had an IOP of 30 mm Hg or higher 4 to 6 hours postoperatively. Compared with preoperatively, an IOP increase of more than 5 mm Hg was seen at 4 to 6 hours in 3 eyes (15%), 2 eyes (10%), and 14 eyes (70%) in the acetazolamide, brinzolamide, and control group, respectively.


CONCLUSIONS
Brinzolamide was as effective as acetazolamide in preventing IOP elevation 4 to 6 hours after phacoemulsification and more effective than acetazolamide at 18 to 24 hours.
Dayanir
Volkan
V
Department of Ophthalmology, School of Medicine, Adnan Menderes University, Aydin, Turkey. vdayanir@adu.edu.tr
Ozcura
Fatin
F
Kir
Erkin
E
Topaloğlu
Aziz
A
Ozkan
Seyhan B
SB
Aktunç
Turgay
T
D000086:Acetazolamide; D000284:Administration, Oral; D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002257:Carbonic Anhydrase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D013449:Sulfonamides / Q000008:administration & dosage / Q000627:therapeutic use*; D013843:Thiazines / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors; D014065:Tonometry, Ocular
D002257:Carbonic Anhydrase Inhibitors; D013449:Sulfonamides; D013843:Thiazines; C111827:brinzolamide; D000086:Acetazolamide