Efficacy of brimonidine in preventing intraocular pressure spikes following phacoemulsification in glaucoma patients.
OBJECTIVE
To measure intraocular pressure (IOP) elevation 6 and 24 hours after phacoemulsification in patients with glaucoma and to investigate the efficacy of brimonidine tartrate 0.2% in preventing IOP rise on the first postoperative day following cataract surgery.


METHODS
In this prospective randomized single-masked study, 86 eyes of 78 patients with well-controlled open-angle glaucoma were scheduled for phacoemulsification surgery. Patients were randomly assigned into 2 groups. Group A received 1 drop of brimonidine tartrate 0.2% and group B, which served as a control group, received 1 drop of artificial tears. Intraocular pressure was measured at baseline, before surgery, and 6 and 24 hours postoperatively.


RESULTS
Within each group, we found a statistically significant difference in IOP between baseline and 6 hours postoperatively (p<0.01) and between 6 and 24 hours (p<0.01). There was no statistically significant difference between baseline IOP and 24-hour values. Comparing the 2 groups, there was no statistically significant difference in preoperative and 24-hour postoperative IOP. Six hours after surgery, the mean IOP in the brimonidine group was 18.52±4.58 mmHg, compared with 20.86±3.79 mmHg in the control group. Treatment with brimonidine tartrate 0.2% significantly reduced postoperative IOP elevation 6 hours following cataract extraction (p=0.009).


CONCLUSIONS
Patients with medically well-controlled glaucoma may experience a substantial increase in IOP shortly after phacoemulsification surgery. Instillation of brimonidine tartrate 0.2%, although it significantly reduced IOP elevation following cataract operation, did not completely prevent IOP spikes.
Kandarakis
Artemios
A
1st Ophthalmology Department, Ophthalmiatrion Eye Hospital of Athens, Sina 2, Athens, Greece. artemiskandarakis@yahoo.gr
Soumplis
Vasileios
V
Karampelas
Michalis
M
Panos
Christos
C
Kyriakos
Nikolaos
N
Baxevanakis
Anastasios
A
Karagiannis
Dimitrios
D
D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D000068438:Brimonidine Tartrate; D005260:Female; D005902:Glaucoma, Open-Angle / Q000150:complications*; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000517:prevention & control; D018918:Phacoemulsification; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D011810:Quinoxalines / Q000008:administration & dosage*; D016037:Single-Blind Method; D013997:Time Factors; D014065:Tonometry, Ocular; D016896:Treatment Outcome; D014792:Visual Acuity
D000959:Antihypertensive Agents; D011810:Quinoxalines; D000068438:Brimonidine Tartrate