COMPARISON OF TOPICAL TIMOLOL GEL TO ORAL ACETAZOLAMIDE IN THE PROPHYLAXIS OF VISCOELASTIC-INDUCED OCULAR HYPERTENSION AFTER PENETRATING KERATOPLASTY

Purpose: Viscoelastic-induced ocular hypertension following penetratin g keratoplasty (PK) may result in endothelial cell loss and optic nerv e damage. Methods: In a prospective, randomized, masked trial, two dos es of oral sustained-release acetazolamide were compared to a single d ose of topical 0.5% timolol gel after 10 PKs. Results: The mean preope rative intraocular pressure (IOP) was 17.4 mm Hg for the oral acetazol amide group and 16.7 mm Hg for the timolol gel group. The mean IOP on the first postoperative day was 17.9 mm Hg with oral acetazolamide and 12.9 mm Hg with timolol gel. One patient developed significant advers e reactions with oral acetazolamide; there were no adverse reactions w ith timolol gel. Conclusion: Prophylactic use of timolol gel for visco elastic-induced ocular hypertension after PK appears to offer better I OP control than oral acetazolamide, with potentially fewer adverse sys temic effects.