Brimonidine 0.15% versus apraclonidine 0.5% for prevention of intraocular pressure elevation after anterior segment laser surgery.
OBJECTIVE
To compare the efficacy and safety of brimonidine 0.15% with those of apraclonidine 0.5% in preventing intraocular pressure (IOP) elevations after anterior segment laser surgery.


METHODS
Massachusetts Eye and Ear Infirmary, Glaucoma Service, Boston, Massachusetts, USA.


METHODS
This double-masked randomized trial 80 eyes of 80 patients who had laser peripheral iridotomy, argon laser trabeculoplasty, or neodymium:YAG laser capsulotomy. Eyes received 1 drop of brimonidine 0.15% or apraclonidine 0.5% before laser surgery. Intraocular pressure, heart rate, and blood pressure were measured before laser surgery and at 1 hour, 3 hours, 24 hours, and 1 week after laser surgery.


RESULTS
Before laser treatment, 41 patients received brimonidine 0.15% and 39 received apraclonidine 0.5%. Thirteen (31.7%) patients in the brimonidine group and 11 (28.2%) in the apraclonidine group had postoperative IOP elevations of 5 mm Hg or more (P = .5). Four patients (9.8%) in the brimonidine group and 3 (7.7%) in the apraclonidine group had IOP increases of 10 mm Hg or more (P = .5). There were no statistically significant changes in mean heart rate or blood pressure in either group except a slight reduction in diastolic blood pressure at 1 hour in the brimonidine group (-4.7 +/- 9.2 mm Hg) compared with that in the apraclonidine group (-0.1 +/- 9.1 mm Hg) (P = .01). No clinically significant side effects were noted in either group.


CONCLUSIONS
A single preoperative drop of brimonidine 0.15% had similar efficacy and safety as apraclonidine 0.5% in preventing IOP elevations immediately after anterior segment laser surgery.
Chen
Teresa C
TC
Harvard Medical School, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Glaucoma Service, Boston, Massachusetts 02114, USA. teresa_chen@meei.harvard.edu
D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage* / Q000009:adverse effects; D000368:Aged; D000869:Anterior Eye Segment / Q000601:surgery*; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects; D001794:Blood Pressure / Q000187:drug effects; D000068438:Brimonidine Tartrate; D003000:Clonidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D032801:Iridectomy; D053685:Laser Therapy; D007903:Lens Capsule, Crystalline / Q000601:surgery; D008297:Male; D009798:Ocular Hypertension / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*; D011810:Quinoxalines / Q000008:administration & dosage* / Q000009:adverse effects; D014130:Trabeculectomy; D016896:Treatment Outcome; D014792:Visual Acuity
D000316:Adrenergic alpha-Agonists; D000959:Antihypertensive Agents; D011810:Quinoxalines; D000068438:Brimonidine Tartrate; C016986:apraclonidine; D003000:Clonidine