LEVOBUNOLOL 0.5-PERCENT AND TIMOLOL 0.5-PERCENT TO PREVENT INTRAOCULAR-PRESSURE ELEVATION AFTER NEODYMIUM-YAG LASER POSTERIOR CAPSULOTOMY

Purpose: To evaluate the prophylactic effect of levobunolol 0.5%, timo lol 0.5%, or vehicle in reducing the incidence of postoperative intrao cular pressure (IOP) spikes of 5 and 10 mm Hg or more in patients havi ng neodymium:YAG (Nd:YAG) laser posterior capsulotomy. Setting: Miami Vision Center, Coral Gables, Florida; Cullen Eye Institute, Baylor Col lege of Medicine, Houston, Texas; Cincinnati Eye Institute, Cincinnati , Ohio; South Texas Cataract and Glaucoma Center, San Antonio, Texas; Mid-South Eye Foundation, Memphis, Tennessee, USA. Methods: This prosp ective, double-masked, randomized study comprised 144 patients having Nd:YAG laser posterior capsulotomy in one eye. One drop of the test me dication was administered preoperatively and one drop on the evening a fter surgery; IOP was measured preoperatively and 1, 2, 3, and 24 hour s postoperatively. Results: Intraocular pressure elevations of 5 mm Hg or more were seen in 1 of 60 patients (2%) in the levobunolol group, 4 of 54 (7%) in the timolol group, and 10 of 28 (36%) in the vehicle g roup. These elevations occurred significantly more frequently in the v ehicle group than in the levobunolol (P <.001) or timolol (P <.004) gr oups. Elevations of 10 mm Hg or more were found in 2 of 28 patients (7 %) treated with vehicle but were not observed in the patients treated with levobunolol or timolol. Conclusions: Levobunolol 0.5% or timolol 0.5% administered preoperatively and again in the evening after Nd:YAG laser capsulotomy effectively blunted the IOP rise that frequently fo llows laser surgery.