TOPICAL 2.0-PERCENT DORZOLAMIDE VS ORAL ACETAZOLAMIDE FOR PREVENTION OF INTRAOCULAR-PRESSURE RISE AFTER NEODYMIUM-YAG LASER POSTERIOR CAPSULOTOMY

Objective: To compare the efficacy and safety of topical 2.0% dorzolam ide hydrochloride with oral acetazolamide in preventing intraocular pr essure (IOP) rise following neodymium:YAG (Nd:YAG) laser posterior cap sulotomy. Design: A prospective,randomized, double-masked, placebo-con trolled study. Patients: Two hundred ten patients undergoing Nd: YAG l aser posterior capsulotomy. Intervention: Pretreatment with dorzolamid e, acetazolamide, or placebo. Dorzolamide administration as a single d rop (1 drop approximate to 20 mu L) 1 hour before capsulotomy. Acetazo lamide administration as a single dose of 125 mg orally 1 hour before capsulotomy. Results: At first and third hour postoperatively, IOPs an d IOP changes from baseline were significantly (P<.001) higher in the placebo group than in the dorzolamide or acetazolamide group. At the s ame time, IOPs and IOP changes from baseline were similar (P>.50) in t he dorzolamide and acetazolamide groups. No patient treated with dorzo lamide or acetazolamide experienced an IOP higher than 30 mm Hg after capsulotomy, but 15.7% of patients receiving placebo had an IOP above this level (P<.001). Of patients receiving placebo, 5.7% experienced I OP higher than 35 mm Hg. No serious side effects were recorded in any of the studied patients. Conclusion: Topical 2.0% dorzolamide and oral acetazolamide, given prophylactically as a single administration 1 ho ur before Nd:YAG laser posterior capsulotomy, have comparable high eff icacy and safety in preventing IOP elevation following this procedure.