The Results of Preoperative Topical Brimonidine Usage in Pterygium Surgery

Uçar, Fikret; Çetinkaya, Servet

doi:10.1089/jop.2019.0085

Cited by 12 publications

(18 citation statements)

References 19 publications

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“…Hosten and Snyder Clinical doses (0.025%). [27][28][29] Brimonidine, in an ophthalmic solution with the lower concentration of 0.025%, received FDA approval in 2017 to reduce the redness of the eye due to minor irritations.…”

Section: Dovepressmentioning

confidence: 99%

<p>Over-the-Counter Ocular Decongestants in the United States – Mechanisms of Action and Clinical Utility for Management of Ocular Redness</p>

Hosten¹,

Snyder²

2020

OPTO

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To manage ocular redness effectively, health-care practitioners require an understanding of the pathophysiology, clinical features and differential diagnosis of ocular redness, as well as comprehensive knowledge of medical therapies available and their pharmacologic properties. This review aims to provide a clinically relevant summary of the current literature on the mechanism of action, efficacy, and safety of current over-the-counter (OTC) decongestants available for reduction of ocular redness due to minor irritations. Currently marketed OTC products indicated for such use in the United States include topical solutions of tetrahydrozoline 0.05%, naphazoline 0.012% to 0.03%, and brimonidine 0.025%. All 3 agents are adrenergic receptor agonists but vary in their receptor-binding profiles: tetrahydrozoline is a selective α1 receptor agonist; naphazoline is a mixed α1/α2 receptor agonist; and brimonidine is a selective α2 receptor agonist. These OTC decongestants produce vasoconstriction of conjunctival blood vessels, which results in a rapid reduction in ocular redness. In general, ocular adverse events reported in published studies of these OTC decongestants were minimal, mild, and transient, with no significant adverse systemic effects. However, ocular decongestants with α1-adrenergic receptor agonist activity can be associated with loss of effectiveness with continued use (ie, tachyphylaxis) and rebound redness upon treatment discontinuation. In clinical trials of the selective α2-adrenergic receptor agonist brimonidine 0.025%, tachyphylaxis was not observed, and rebound redness was rarely reported.

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Section: Dovepressmentioning

confidence: 99%

<p>Over-the-Counter Ocular Decongestants in the United States – Mechanisms of Action and Clinical Utility for Management of Ocular Redness</p>

Hosten¹,

Snyder²

2020

OPTO

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“…Therefore, our results cannot be compared with any previous study. However, some previous research has demonstrated the preventive effect of brimonidine to avoid the occurrence of subconjunctival hemorrhage in other ophthalmic surgeries, such as laser in situ keratomileusis (LASIK), intravitreal injections, strabismus surgery and phacoemulsi cation cataract surgery [4][5][6][7]. In any case, it should be noted that vitreoretinal surgery is longer in duration and includes more manipulation of the ocular (conjunctiva-sclera-choroid) tissues, especially when introducing microcannulas, than other microincisional surgeries.…”

Section: Discussionmentioning

confidence: 99%

“…These authors concluded that the preoperative use of brimonidine could signi cantly reduce the incidence of this condition in subjects undergoing this surgical procedure. A case-control study was also conducted to evaluate the e cacy of brimonidine to reduce the level of conjunctival and episcleral hyperemia, and postoperative bleeding after pterygium surgery [6]. This clinical research concluded that brimonidine reduced the level of postoperative bleeding in at least 50% of patients using this prophylactic treatment compared to a control group.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have already investigated the prophylactic effect of brimonidine drops in preventing subconjunctival hemorrhage in some microincisional ophthalmic surgeries, such as intravitreal injections, cataract surgery, laser in situ keratomileusis (LASIK) or strabismus surgery [4][5][6][7]. To this date, there are no studies reported investigating this prophylactic effect after 23G microincisional vitreoretinal surgery.…”

Section: Introductionmentioning

confidence: 99%

“…It is also available as a 0.33% topical ointment for treating non-transient facial erythema in adults with rosacea [3]. Additionally, it has shown its vasoconstrictor e cacy at low doses (0.025 to 0.2%), with the potential of reducing bleeding during ophthalmic surgery [4][5][6] or intravitreal injections [7], and consequently promoting a conjunctival whitening [8] prior to any eye surgery. Brimonidine´s cosmetic eye whitening effect has also been recently approved by the FDA [9].…”

Section: Introductionmentioning

confidence: 99%

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Prophylactic Effect of Brimonidine To Minimize The Incidence of Subconjunctival Hemorrhage after 23G Pars Plana Vitrectomy

Desco¹,

Martín²,

Mataix-Boronat³

et al. 2020

Preprint

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BackgroundSeveral studies have already investigated the prophylactic effect of brimonidine drops in preventing subconjunctival hemorrhage in some microincisional ophthalmic surgeries. The aim of the current study was to determine if subconjunctival hemorrhage after 23G pars plana vitrectomy (PPV) could be prevented with the use of prophylactic topical brimonidine.Main textIt was a phase III, prospective, interventional, randomized, controlled single-center clinical trial with a follow-up of 2 weeks. A total of 77 eyes (mean age: 68.4 ± 10.7 years) undergoing 23G PPV were included and randomized into 2 groups: group 1 including 41 patients receiving prophylactic preoperative treatment with brimonidine, and Group 2 (control group) including 36 patients not receiving this prophylactic treatment. Differences in terms of number of conjunctival quadrants affected with subconjunctival hemorrhage were evaluated in each of the follow-up visits. The presence of subconjunctival hemorrhage was similar in both groups the first days after surgery (p > 0.05). At the last visit, this condition was significantly more frequent in control group where there was a significant difference, being more frequent in the control group (7.3% vs. 28.6%, p = 0.022). The number of conjunctival quadrants affected was also similar in both groups, except for the last visit in which most of patients treated with brimonidine (92.7%) showed no bleeding compared to 71.4% in control group. No effect on the efficacy of brimonidine treatment of the presence of blood hypertension, diabetes and antiplatelet or anticoagulant treatment was observed.ConclusionsBrimonidine seems to be a useful option to decrease subconjunctival hemorrhage after micro-incisional vitreoretinal surgery or improve its resolution during the first postoperative week. This finding should be mainly due to the vasoconstrictor effect of brimonidine.Trial registrationEudraCT, 2012-002895-15. Registered 19 December 2012, https://www.clinicaltrialsregister.eu/ctr-search/search?query=2012-002895-15

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Brimonidine tartrate ophthalmic solution 0.025% for redness relief: an overview of safety and efficacy

Lee

Kim

2022

Expert Review of Clinical Pharmacology

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The Results of Preoperative Topical Brimonidine Usage in Pterygium Surgery

Cited by 12 publications

References 19 publications

<p>Over-the-Counter Ocular Decongestants in the United States – Mechanisms of Action and Clinical Utility for Management of Ocular Redness</p>

<p>Over-the-Counter Ocular Decongestants in the United States – Mechanisms of Action and Clinical Utility for Management of Ocular Redness</p>

Prophylactic Effect of Brimonidine To Minimize The Incidence of Subconjunctival Hemorrhage after 23G Pars Plana Vitrectomy

Brimonidine tartrate ophthalmic solution 0.025% for redness relief: an overview of safety and efficacy

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