Fixed combination brimonidine-timolol versus brimonidine for treatment of intraocular pressure elevation after neodymium:YAG laser posterior capsulotomy.
OBJECTIVE
To evaluate the efficacy of fixed combination brimonidine-timolol (FCBT) in comparison with brimonidine tartrate 0.2% and control for the treatment of intraocular pressure (IOP) spikes after neodymium:YAG (Nd:YAG) laser posterior capsulotomy.


METHODS
One hundred five eyes of 105 patients were enrolled in the study. Patients were randomized to 3 groups (each group, including 35 patients): the FCBT group that received 1 drop of FCBT, the brimonidine group that received 1 drop of brimonidine tartrate 0.2%, and the control group that received 1 drop of artificial tear, 1 h before the laser procedure. Postoperative IOP measurements were performed at 1st, 2nd, 3rd, 24th hours, and seventh day.


RESULTS
The mean IOP changes from baseline were statistically different between the study groups at first, second, and third hours (all P<0.001). Pairwise comparisons showed that although the mean IOP changes of the treatment groups were similar at 1st and 24th hours and seventh day (all P>0.05), the IOP levels of the brimonidine group were less reduced from baseline than the FCBT group at second and third hours (P=0.01 and P=0.03, respectively). The differences among the study groups concerning the incidence of IOP elevations of ≥5 or ≥10 mmHg were statistically significant (P=0.007, P=0.04, respectively). However, the differences between the treatment groups were not statistically significant (both P>0.05).


CONCLUSIONS
This study has shown that preoperative instillation of 1-drop FCBT was safe and effective for preventing IOP spikes after Nd:YAG laser posterior capsulotomy. FCBT may be a better option than brimonidine tartrate 0.2%, which is one of the current standard prophylaxes for these spikes.
Department of Ophthalmology, Recep Tayyip Erdoğan University Medical School, Rize, Turkey. veysioner@gmail.com
Veysi
V
Öner
Mehmet Fuat
MF
Alakuş
Mehmet
M
Taş
Kemal
K
Türkyılmaz
Yalçın
Y
Işcan
D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000068438:Brimonidine Tartrate; D058442:Capsule Opacification / Q000601:surgery; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D053844:Lasers, Solid-State / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects / Q000379:methods; D011300:Preoperative Care; D011810:Quinoxalines / Q000008:administration & dosage / Q000627:therapeutic use*; D013999:Timolol / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D004338:Drug Combinations; D011810:Quinoxalines; D000068438:Brimonidine Tartrate; D013999:Timolol