Bimatoprost 0.03% versus brimonidine 0.2% in the prevention of intraocular pressure spike following neodymium:yttrium–aluminum–garnet laser posterior capsulotomy.
OBJECTIVE
The aim of this study was to compare the efficacy of bimatoprost 0.03% with brimonidine 0.2% in preventing intraocular pressure (IOP) elevations after neodymium:yttrium–aluminum–garnet (Nd:YAG) laser posterior capsulotomy.


METHODS
In this prospective, randomized, double-masked study, 195 eyes of 195 consecutive patients who had YAG laser capsulotomy for posterior capsule opacification were recruited. Eyes received either 1 drop of bimatoprost 0.03% (98 patients) or brimonidine 0.2% (97 patients) at 1h before laser surgery. A masked observer measured IOP by Goldmann applanation tonometry before treatment and after treatment at 1h, 3h, 24h, and 7 days. Inflammation was evaluated after surgery. Formation of cystoid macular edema was assessed by measuring the macular thickness before and after laser surgery.


RESULTS
The average peak of postoperative IOP elevation was 2.2±3.9mm Hg in the bimatoprost 0.03% and 3.6±3.1mm Hg in the brimonidine 0.2% group. The difference was statistically significant (P<0.001). Postoperative IOP elevations of 10mm Hg or more occurred in 1 eye (1.56%) in the bimatoprost 0.03% group and 5 eyes (7.35%) in the brimonidine 0.2%. This difference was statistically significant (P<0.001). Macular edema and anterior chamber reaction were not observed related to bimatoprost. No clinically significant side effects were noted in either group.


CONCLUSIONS
Our results indicate that prophylactic use of bimatoprost 0.03% is more effective than brimonidine 0.2% in preventing IOP elevation immediately after YAG laser capsulotomy. Bimatoprost 0.03% as a prostamide analog may provide new option for preventing IOP elevation after YAG laser capsulotomy.
Artunay
Ozgur
O
1 Department of Ophthalmology, Istanbul Bilim University , Istanbul, Turkey .
Yuzbasioglu
Erdal
E
Unal
Mustafa
M
Rasier
Rifat
R
Sengul
Alper
A
Bahcecioglu
Halil
H
D000368:Aged; D000369:Aged, 80 and over; D000577:Amides / Q000009:adverse effects / Q000494:pharmacology*; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000494:pharmacology*; D000069580:Bimatoprost; D000068438:Brimonidine Tartrate; D058442:Capsule Opacification; D002386:Cataract / Q000188:drug therapy; D003008:Cloprostenol / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology; D005260:Female; D005901:Glaucoma / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D053685:Laser Therapy / Q000009:adverse effects; D053844:Lasers, Solid-State / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009354:Neodymium; D009798:Ocular Hypertension / Q000188:drug therapy / Q000517:prevention & control; D009883:Ophthalmic Solutions / Q000627:therapeutic use; D057852:Posterior Capsule of the Lens / Q000601:surgery*; D011810:Quinoxalines / Q000009:adverse effects / Q000494:pharmacology*; D014065:Tonometry, Ocular
D000577:Amides; D000959:Antihypertensive Agents; D009883:Ophthalmic Solutions; D011810:Quinoxalines; D009354:Neodymium; D003008:Cloprostenol; D000068438:Brimonidine Tartrate; D000069580:Bimatoprost