title: Effect of alpha-2-agonist premedication on intraocular pressure after selective laser trabeculoplasty.
abstract: OBJECTIVE
  To determine the effect of alpha-2-agonist (AA) premedication (PM) on intraocular pressure (IOP) following selective laser trabeculoplasty (SLT).
  
  
  METHODS
  Retrospective cohort study of all patients undergoing 360° SLT at an institution with two prevalent practice patterns consisting of SLT performed with PM and without premedication (NPM) with AA. The association between pre- and post-operative IOP was evaluated using a linear regression model in 49 (59%) PM and 34 (41%) NPM eyes.
  
  
  RESULTS
  The prevalence of IOP elevations up to 5 mmHg 1 h postoperatively was similar in both groups, occurring in 18% of PM and in 15% of NPM. Elevations above 5 mmHg were seen in 4% of PM and 8% of NPM (P = 0.732). After correcting for age, gender, diagnosis, number of medications, and preoperative IOP, the presence or absence of AA PM had no significant association with any postoperative IOP (P > 0.5).
  
  
  CONCLUSIONS
  The practice of using AAs before SLT and measuring IOP at 1 h has not been validated yet adds to expenses and workflow burden. Our retrospective study showed no significant correlation between PM and postoperative or longer-term IOP. IOP at 1 h should be measured in patients who cannot tolerate transient pressure elevations. Further studies are needed to elucidate this relationship.
authors: Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA.
authors: Julius T
authors: JT
authors: Oatts
authors: Xiaofei
authors: X
authors: Wang
authors: Nils A
authors: NA
authors: Loewen
mesh_terms: D058647:Adrenergic alpha-2 Receptor Agonists / Q000627:therapeutic use*; D000368:Aged; D000068438:Brimonidine Tartrate / Q000627:therapeutic use; D003000:Clonidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D005260:Female; D005902:Glaucoma, Open-Angle / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D017075:Laser Coagulation / Q000379:methods*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000517:prevention & control*; D011292:Premedication; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D014130:Trabeculectomy / Q000379:methods*
chemical_list: D058647:Adrenergic alpha-2 Receptor Agonists; D000068438:Brimonidine Tartrate; C016986:apraclonidine; D003000:Clonidine