Effects of prophylactic use of brimonidine 0.2% on intraocular pressure after YAG-capsulotomy
Abstract
Background: Rise in intraocular pressure (IOP) is the commonest complication after YAG posterior capsulotomy. As there are different opinions regarding use of anti-glaucoma therapy before YAG, we compared post-YAG IOP between the patients who had Brimonidine eye drops and those who did not have any anti-glaucoma treatment.
Material and methods: It was a prospective study that included patients who had undergone uneventful phacoemulsification with foldable intraocular lens implantation and YAG posterior capsulotomy. One hundred fifty patients were divided into two groups; (a group with prophylactic brimonidine 0.2% eye drops before laser and a group without any anti-glaucoma therapy). Intraocular pressure was checked pre-laser and one hour after laser procedure.
Results: Out of 150 patients, 78 were in brimonidine group and 72 in the control group. The mean age of the patients was 60.39 ± 12.98 years. In the brimonidine group, IOP was 12.56 ± 2.38 mm Hg and 12.29 ± 3.64 mm Hg before and after YAG, respectively. In the control group, IOP was 12.24 ± 1.53 mm Hg and 13.38 ± 2.84 mm Hg before and after YAG. Brimonidine 0.2% caused a decrease in IOP, but the post-laser IOP difference between the two groups was not statistically significant. The change in IOP before and after using brimonidine 0.2% was also not statistically significant.
Conclusion: Every patient undergoing YAG capsulotomy does not require prophylactic anti-glaucoma therapy. Only the patients prone to high IOP, glaucoma suspects, and diagnosed cases of glaucoma should be given prophylactic treatment.
Keywords: glaucomaintraocular pressureYAG capsulotomybrimonidinetrabeculitis
References
- MacEwen CJ, Dutton GN. Neodymium-YAG laser in the management of posterior capsular opacification--complications and current trends. Trans Ophthalmol Soc U K. 1986; 105 ( Pt 3): 337–344.
- Lin JC, Katz LJ, Spaeth GL, et al. Intraocular pressure control after Nd:YAG laser posterior capsulotomy in eyes with glaucoma. Br J Ophthalmol. 2008; 92(3): 337–339.
- Minello AA, Prata Junior JA, Mello PA. [Efficacy of topic ocular hipotensive agents after posterior capsulotomy]. Arq Bras Oftalmol. 2008; 71(5): 706–710.
- Shani L, David R, Tessler Z, et al. Intraocular pressure after neodymium:YAG laser treatments in the anterior segment. J Cataract Refract Surg. 1994; 20(4): 455–458.
- Ari S, Cingü AK, Sahin A, et al. The effects of Nd:YAG laser posterior capsulotomy on macular thickness, intraocular pressure, and visual acuity. Ophthalmic Surg Lasers Imaging. 2012; 43(5): 395–400.
- Thiab HH. Changes in intraocular pressure after ND-yag laser posterior capsulotomy. Int J Clin Exp Ophthalmol. 2020; 4(1): 021–030.
- Parajuli A, Joshi P, Subedi P, et al. Effect of Nd:YAG laser posterior capsulotomy on intraocular pressure, refraction, anterior chamber depth, and macular thickness. Clin Ophthalmol. 2019; 13: 945–952.
- Karahan E, Tuncer I, Zengin MO. The Effect of ND:YAG Laser Posterior Capsulotomy Size on Refraction, Intraocular Pressure, and Macular Thickness. J Ophthalmol. 2014; 2014: 846385.
- Achiron A. Intraocular Pressure Spikes following Neodymium-doped Yttrium Aluminum Garnet Laser Capsulotomy: Current Prevalence and Management in Israel. J Curr Glaucoma Pract. 2017; 11(2): 63–66.
- Nesher R, Kolker AE. Failure of apraclonidine to prevent delayed IOP elevation after Nd:YAG laser posterior capsulotomy. Trans Am Ophthalmol Soc. 1990; 88: 229–232 (discussion 233–236).
- Chen TC, Ang RT, Grosskreutz CL, et al. Brimonidine 0.2% versus apraclonidine 0.5% for prevention of intraocular pressure elevations after anterior segment laser surgery. Ophthalmology. 2001; 108(6): 1033–1038.
- Rao CMS, Satyasrinivas V, Muralikrishna V, et al. Clinical Study of Visual Outcome and Intraocular Pressure Changes Following Neodymium-doped Yttrium Aluminum Garnet Laser Capsulotomy in Post-operative Cataract Patients with Posterior Capsule Opacification. . Intern J Sci Study. 2017; 5: 76–82.
- Singhal D, Desai R, Desai S, et al. Use of topical brimonidine to prevent intraocular pressure elevations following Nd: YAG-laser posterior capsulotomy. J Pharmacol Pharmacother. 2011; 2(2): 104–106.
- Seong GJ, Lee YG, Lee JH, et al. Effect of 0.2% brimonidine in preventing intraocular pressure elevation after Nd:YAG laser posterior capsulotomy. Ophthalmic Surg Lasers. 2000; 31(4): 308–314.
- Calli U. The effect of prophylactic topical brimonidine on intraocular pressure after Nd: YAG laser posterior capsulotomy. J Kartal Train Res Hosp. 2016.
- Saleem M, Manzoor M, Shehzad A, et al. Brimonidine efficacy on intraocular pressure control following ND: YAG laser capsulotomy. Pak Armed Forces Med J. 2018; 68(2): 245–249.
- Niazi M, Rauf A, Nadeem Y. Brimonidine for Prevention of Intraocular Pressure Elevation after YAG-Posterior Capsulotomy. Pak J Ophthalmol. 2020; 36(2).
- Yellamelli A, Baldev V, Batra N, et al. Effect of topical brimonidine 0.15% versus timolol 0.5% to prevent intraocular pressure elevation after nd: yag laser capsulotomy. J Evid Based Med Healthc. 2017; 4(55): 3365–3368.
- Manandhar LD, Gurung N, Shrestha K, et al. Study of Intraocular Pressure following Neodynium Yttrium Aluminium Garnet Laser Capsulotomy with the Use of Brimonidine: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc. 2021; 59(233): 15–18.
- Murtaza B, Hussain AW, Haq AU, et al. Changes in intraocular pressure following high energy Nd-Yag laser posterior capsulotomy. Pak Armed Forces Med J. 2018; 68: 872–875.