Use of Topical Brimonidine to Prevent Intraocular Pressure Elevations Following Nd:YAG-Laser Posterior Capsulotomy

BACKGROUND AND OBJECTIVE: To evaluate the efficacy of topical brimonidine tartrate 0.2% (Allergan, Irvine, CA) in the prophylactic treatment of acute intraocular pressure (IOP) rises following Nd:YAG laser posterior capsulotomy. PATIENTS AND METHODS: This was a double-masked, randomized, placebo-controlled clinical study in 60 patients who underwent Nd:YAG laser posterior capsulotomy after extracapsular cataract extraction. Two doses of brimonidine or vehicle were administered before and after capsulotomy. Intraocular pressure was measured prior to commencing instillation and for 48 hours postoperatively. RESULTS: Following posterior capsulotomy, the brimonidine group showed a significant mean percent reduction in IOP, while the vehicle group showed a significant mean percent increase in IOP. At 48 hours, mean IOP of both groups had returned to pre-laser level. There were no differences between the 2 groups in the incidence of clinical adverse experiences. CONCLUSION: Two-dose brimonidine tartrate 0.2% effectively prevents acute IOP rises after Nd:YAG laser posterior capsulotomy.