EFFECTIVENESS OF APRACLONIDINE AND ACETAZOLAMIDE IN PREVENTING POSTOPERATIVE INTRAOCULAR-PRESSURE SPIKES AFTER EXTRACAPSULAR CATARACT-EXTRACTION

We studied the effectiveness of two prophylactic agents in controlling early postoperative intraocular pressure (IOP) increases after catara ct surgery. Fifty-four nonglaucomatous patients received either topica l 1% apraclonidine, one drop before and after surgery, or sustained-re lease acetazolamide, 500 mg, or no medication at the completion of pla nned extracapsular cataract extraction (ECCE). Mean baseline IOPs were similar among patients randomized to the apraclonidine, acetazolamide , and control groups: 15.29 mm Hg, 15.33 mm Hg, and 14.26 mm Hg, respe ctively. At 3 hours postoperatively, IOPs were significantly lower in the apraclonidine group (11.13 mm Hg, P = .035), nonsignificantly lowe r in the acetazolamide group (13.3 mm Hg, P = .17), and significantly increased in the control group (21.32 mm Hg, P = .003). One eye in the apraclonidine group and six in the control group had IOPs greater tha n 30 mm Hg. At 24 hours, the only statistically significant difference was in the control group, whose mean IOPs remained elevated (21.83 mm Hg, P = .0008), One eye in the apraclonidine group, two in the acetaz olamide group, and five in the control group had IOPs greater than 30 mm Hg. We found a significant early IOP reduction with apraclonidine g iven topically preoperatively and at the completion of planned ECCE.