Comparing brimonidine 0.2% to apraclonidine 1.0% in the prevention of intraocular pressure elevation and their pupillary effects following laser peripheral iridotomy

Yuen, Nancy S.Y.; Cheung, Pik-Yuen; Hui, Sui Ping

doi:10.1007/s10384-004-0149-9

Cited by 27 publications

(14 citation statements)

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“…This incidence of clinically significant IOP elevation after LPI was, as expected, greatly lower than noted in previous reports in which no pretreatment was used. 13,15 Shani et al 15 reported a series of 212 eyes treated by Nd:YAG laser without pretreatment with any pressure-lowering medication. Despite the lower energy applied (26.9±28 mJ) in the white eyes in their study, 21.2% of all cases had an IOP elevation of more than 10 mmHg and 2.8% had an IOP increase of more than 20 mmHg.…”

Section: Discussionmentioning

confidence: 99%

“…Laser peripheral iridotomy can cause an acute and (usually) transient posttreatment rise in intraocular pressure (IOP) in some patients. 10,11 Although previous studies indicate that the incidence of IOP spikes is reduced greatly in eyes pretreated with ocular hypotensive agents, 10,12,13 the frequency and severity of IOP elevation after prophylactic LPI remains uncertain, particularly in Chinese eyes, which typically have thicker irises and thus require higher levels of energy to perforate. This study investigated the immediate impact of LPI on IOP in Chinese eyes with narrow angles, but no evidence of peripheral anterior synechia, elevated IOP, or glaucomatous optic neuropathy.…”

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confidence: 99%

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Immediate Changes in Intraocular Pressure after Laser Peripheral Iridotomy in Primary Angle-Closure Suspects

Jiang¹,

Chang²,

Foster³

et al. 2012

Ophthalmology

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Purpose To determine the immediate changes in intraocular pressure (IOP) after laser peripheral iridotomy in primary angle-closure suspects. Design Prospective, randomized controlled trial (split-body design). Participants Seven hundred thirty-four Chinese people 50 to 70 years of age. Methods Primary angle-closure suspects underwent iridotomy using a neodymium:yttrium–aluminum–garnet laser in 1 randomly selected eye, with the fellow eye serving as a control. Intraocular pressure was measured using Goldmann applanation tonometry before treatment and 1 hour and 2 weeks after treatment. Total energy used and complications were recorded. Risk factors for IOP rise after laser peripheral iridotomy were investigated. Main Outcome Measures Intraocular pressure. Results The proportion of treated eyes with an IOP spike (an elevation of ≥8 mmHg more than baseline) at 1 hour and 2 weeks after treatment was 9.8% (95% confidence interval [CI], 7.7–12.0) and 0.82% (95% CI, 0.2–1.5), respectively. Only 4 (0.54%) of 734 eyes (95% CI, 0.01–1.08) had an immediate posttreatment IOP of 30 mmHg or more and needed medical intervention. The average IOP 1 hour after treatment was 17.5±4.7 mmHg in the treated eyes, as compared with 15.2±2.6 mmHg in controls. At 2 weeks after treatment, these values were 15.6±3.4 mmHg in treated eyes and 15.1±2.7 mmHg in controls (P<0.001). No significant difference was detected in the baseline IOP of the treated and untreated eyes. Logistic regression showed that the incidence of IOP spike was associated with greater laser energy used and shallower central anterior chamber. Conclusions Laser peripheral iridotomy in primary angle-closure suspects resulted in significant IOP rise in 9.8% and 0.82% of cases at 1 hour and 2 weeks, respectively. Eyes in which more laser energy and a higher number of laser pulses were used and those with shallower central anterior chambers were at increased risk for IOP spikes at 1 hour after laser peripheral iridotomy.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Immediate Changes in Intraocular Pressure after Laser Peripheral Iridotomy in Primary Angle-Closure Suspects

Jiang¹,

Chang²,

Foster³

et al. 2012

Ophthalmology

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“…Teresa, Nancy and Unal in their study, showed that the use of brimonidine 0.15% before surgery is comparable to the efficacy and safeness of apraclonidine 0.5% and 0.1% in preventing IOP elevation after laser anterior segment capsulotomy. 5,6,16 Seong et al in a study identified the positive influence of brimonidine 0.2% as an eye drop in preventing IOP elevation after YAG laser capsulotomy. 7 Yeom and et al in a study used two different concentrations of brimonidine (0.2% and 0.15%) and showed their high effectiveness in preventing IOP rise after YAG laser capsulotomy and also they suggest that both drugs had a similar impact on preventing IOP increase.…”

Section: Xalatan Brimonidinementioning

confidence: 99%

Compare Brimonidine 0.2% versus Latanoprost 0.005% (Xalatan) in preventing intraocular pressure after YAG laser posterior capsulotomy in patients visiting ophthalmology clinic in Ardabil city

Ojaghi

Masoumi

Eskandar-Sani

2016

Int J Basic Clin Pharmacol

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Background: The transient increase of intraocular pressure (IOP) following neodymium YAG laser capsulotomy can occur in a significant number of patients, which requires prophylactic treatment with IOP reducing drugs, and in some patients, postoperative IOP monitoring. This study was performed to compare the efficacy of brimonidine 0.2% versus latanoprost0.005% (Xalatan) in preventing the IOP elevation after YAG laser posterior capsulotomy in patients visiting ophthalmology clinic in Alavi Hospital.Methods: This study was a randomized, double-blind clinical trial that included 100 patients who had developed posterior capsule opacification (PCO) as a result of previous cataract surgery and were candidate for undergoing YAG laser posterior capsulotomy. The patients were randomly divided into two groups of 50 patients. One group received brimonidine 0.2% one hour before surgery, and the other group received Xalatan 0.005% in the night before laser surgery. In both groups the patients' IOP was measured in baseline, 1, 2, 3, 24 hours, 3 days and one week after surgery. The gathered data were analyzed using statistical methods in SPSS.16.Results: The mean IOP, 1, 2, 3, and 24 hours, 3 days, and one week after surgery didn't show any significant difference between two groups. IOP one hour before surgery changed significantly compared to one hour after surgery and a statistically significant relationship was found between the two groups, though at other times of measurement, the differences were not significant.Conclusions: Results showed that using Brimonidine 0.2% or Latanoprost 0.005% as prophylactic before YAG laser posterior capsulotomy could be effective in preventing IOP after treatment.

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“…18 Pre-and/or posttreatment with brimonidine 0.2 % or apraclonidine 0.5 % is helpful in preventing IOP spikes. 19 Care must be provided for patients with advanced PACG as pressure spikes may be severe and prolonged, causing further vision loss in a compromised nerve.…”

Section: Complicationsmentioning

confidence: 99%

Lasers in Primary Angle Closure

Chee¹,

Srinivasan²,

Cheng³

2015

US Ophthalmic Review

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Glaucoma Touch MEdical MEdia 99 Glaucoma is a leading cause of blindness worldwide. 1 Broadly speaking, there are two types of glaucoma: open angle and angle closure. Unlike open angle where the angle between the iris and cornea is open, angleclosure glaucoma is an optic neuropathy secondary to raised intraocular pressure (IOP) due to the closure of the drainage angle. Worldwide, the mean prevalence of angle closure glaucoma is 0.69 %, and 86 % of those affected were from Asia. 1 Although angle closure is less common, it is potentially more blinding, though early intervention could prevent progression of disease. Patients with acute angle closure often present with acute red painful eye but symptoms of chronic angle closure are often silent. Angle closure is classified according to gonioscopy findings, IOP, and optic nerve damage (see Table 1). Laser in angle closure has been used since the 1970s, and its application had expanded and evolved over the years. 2 This article reviews the type of lasers used in primary angle closure glaucoma (PACG), their efficacy, and complications. Laser Peripheral Iridotomy Indications and EfficacyLaser peripheral iridotomy (LPI) is a treatment that creates an opening in the peripheral iris to allow an alternative pathway for aqueous to flow between the anterior and posterior chamber, bypassing the pupil. This eliminates the element of pupil block, which is the most common contributing factor to angle closure in PACG. 3 There are many other factors that contribute to the narrowing of the drainage angle, which includes lens vault, cataract, axial length, iris root thickness, and plateau iris configuration. 4 LPI is indicated in acute ACG (AACG), in the fellow eye of AACG, PAC suspects (PACS), PAC, and PACG (see Table 1). There is some evidence that LPI can be helpful in phacomorphic glaucoma and pigment dispersion syndrome. 3The effectiveness of LPI in preventing glaucoma, controlling IOP, and improving angle width, varies according to severity of disease at presentation as well as mechanism underlying angle closure. LPI is successful in preventing acute PAC (APAC) in the fellow eye of patients who had APAC. When followed up over 4 years, none of the fellow eyes treated with LPI developed APAC while only 11.2 % of cases had an increase in IOP during follow-up, which required additional medical or surgical intervention. 5 LPI can also be useful in controlling IOP and angle width. 5,6 The Liwan Eye study in China reported a mean IOP reduction of 3 mmHg and increase in anterior chamber angle width of 2 units in Shaffer angle grade, 2 weeks post-LPI. 6 By contrast, a Vietnamese study with a longer mean follow-up time of 12 years reported 22.2 % of patients with PACS progressed to PAC despite LPI. 7 The need for additional intervention to control IOP after LPI for PAC, especially in PACG, has been a relatively consistent finding in various studies. Peng et al. reported 42.2 % of PAC and all PACG required additional interventions to control IOP. 7 Cumba et al. also reported a significant ...

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Comparing brimonidine 0.2% to apraclonidine 1.0% in the prevention of intraocular pressure elevation and their pupillary effects following laser peripheral iridotomy

Abstract: Brimonidine 0.2% was found to have an efficacy comparable to that of apraclonidine 1.0% in preventing post LPI IOP spikes. Apraclonidine 1.0% tends to have a pupil dilating effect while brimonidine 0.2% tends to constrict the pupil.

Cited by 27 publications

References 21 publications

Immediate Changes in Intraocular Pressure after Laser Peripheral Iridotomy in Primary Angle-Closure Suspects

Immediate Changes in Intraocular Pressure after Laser Peripheral Iridotomy in Primary Angle-Closure Suspects

Compare Brimonidine 0.2% versus Latanoprost 0.005% (Xalatan) in preventing intraocular pressure after YAG laser posterior capsulotomy in patients visiting ophthalmology clinic in Ardabil city

Lasers in Primary Angle Closure

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