PROPHYLACTIC USE OF APRACLONIDINE FOR INTRAOCULAR-PRESSURE INCREASE AFTER 180-DEGREE ARGON-LASER TRABECULOPLASTY

A prospective, randomized, double-blind study compared the results of 1% apraclonidine use after an argon laser trabeculoplasty with results obtained after a 180-degree argon laser trabeculoplasty without aprac lonidine. In group I, 16 eyes of the 16 primary open-angle glaucoma pa tients received apraclonidine 1% both 1 hour and immediately after 180 -degree argon laser trabeculoplasty (ALT). In group II, 16 eyes of the primary open-angle glaucoma patients were treated with 180-degree ALT and with a placebo 1 hour before and immediately after the procedure. In group III, 16 eyes of the 16 primary open-angle glaucoma patients received apraclonidine 1% both 1 hour and immediately after 360-degree ALT. The average intraocular pressure (IOP) change and the frequency of pressure elevations at 1, 2, and 3 hours postoperatively were evalu ated in each group. The mean maximal change in intraocular pressure wa s -7.4 +/- 4.5 mm Hg in group 1, 0.6 +/- 7.2 mm Hg in group II, and -2 .9 +/- 6.7 mm Hg in group III. The incidence of increase in intraocula r pressure was O in group 1, 37.5% in group II, and 25% in group III. According to these results, 360-degree ALT with perioperative 1% aprac lonidine appears to produce the same IOP change as the 180-degree ALT treatment without apraclonidine (P > 0.05), but the 180-degree ALT tre atment with perioperative use of 1% apraclonidine may be safer than th e other two alternatives (P < 0.001).