Control of intraocular pressure elevations after argon laser trabeculoplasty

Selective Laser Trabeculoplasty Versus Medical Therapy as Initial Treatment of Glaucoma

“…Postlaser trabeculoplasty IOP spikes are well recognized, but rarely pose a serious risk especially with the use of topical a-agonists prophylactically. 63,64 Emergent filtration surgery has been reported in high-risk eyes (heavily pigmented angles-pigmentary dispersion syndrome) that have sustained marked IOP elevation after SLT. 65 In this study there were no episodes of sustained IOP elevation, formation of peripheral anterior synechiae, or persistent uveitis after SLT.…”

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

“…16,17 A few other studies have reported its use in controlling the post-laser IOP spikes in various anterior segment laser procedures such as Nd-YAG LPI and posterior capsulotomy. 15,18,19 LPI is one of the most commonly performed laser procedures in the Asia-Pacific region, where closed-angle glaucoma is prevalent.…”

“…Brimonidine has been shown to be effective in controlling IOP spikes after various anterior segment laser procedures. [15][16][17][18][19][20] However, owing to the higher lipophilicity of brimonidine compared with apraclonidine, studies have shown a decrease in systolic blood pressure and heart rate after 21 days of continued use of the 0.5% preparation; the 0.2% preparation, however, has only a minimal effect on the cardiovascular and central nervous system. 21 Brimonidine 0.2% may be considered safer than the 0.5% preparation in patients who require LPI.…”

Lasertrabekuloplastik

“…Ein α-2-Agonist, Apraclonidin oder Brimonidin, wird ebenfalls eingesetzt, um die Druckspitzen zu minimieren. Bei Patienten, die einen α-2-Agonisten vor der Behandlung erhalten, treten postoperativ keine Druckspitzen auf, die größer als 10 mmHg sind; die Wirkung von Apraclonidin und Brimonidin ist dabei vergleichbar [63]. Patienten, bei denen der Einsatz von α-2-Agonisten nicht möglich ist oder bei denen ein α-2-Agonist bereits ein Teil der regelmäßigen medikamentösen Therapie ist, sollte präoperativ eine Acetazolamid-Tablette verabreicht werden.…”