APRACLONIDINE AND ANTERIOR SEGMENT LASER-SURGERY - COMPARISON OF 0.5-PERCENT VERSUS 1.0-PERCENT APRACLONIDINE FOR PREVENTION OF POSTOPERATIVE INTRAOCULAR-PRESSURE RISE

Purpose: To compare the efficacy of 0.5% and 1.0% apraclonidine in pre venting laser-induced intraocular pressure (IOP) elevation after trabe culoplasty, neodymium: YAG (Nd:YAG) iridotomy, and capsulotomy. Method s: This is a prospective, masked, and randomized study of 83 patients undergoing trabeculoplasty, 62 patients undergoing iridotomy, and 57 p atients undergoing capsulotomy. Surgical eyes received one drop of 0.5 % or 1.0% apraclonidine immediately after surgery. Results: Intraocula r pressure reduced 2 hours after trabeculoplasty in the 0.5% (P = 0.02 8) and 1.0% (P = 0.004) groups. Intraocular pressure was higher than b aseline in a greater number of eyes treated with 0.5% (12 of 39 eyes, 31%) compared with 1.0% apraclonidine (5 of 44 eyes, 11%) (P = 0.032). Intraocular pressure in eyes with a narrow chamber angle was reduced in 16 (85%) of 19 eyes treated with 0.5% and in 10 (84%) of 12 eyes tr eated with 1.0% apraclonidine after iridotomy. Of patients with chroni c angle-closure glaucoma, IOP was similar to prelaser values in 11 (69 %) of 16 eyes treated with 0.5% (P > 0.7) and 12 (80%) of 15 eyes trea ted with 1.0% apraclonidine (P > 0.3). In patients undergoing capsulot omy, pressure was significantly lowered in the 0.5% group (P = 0.04) b ut not in the 1.0% apraclonidine group. After capsulotomy, both treatm ent groups had similar (P > 0.3) numbers of eyes with an IOP less than baseline (83% for 0.5% apraclonidine and 81% for 1.0% apraclonidine). Conclusion: The single postoperative administration of 0.5% apracloni dine is as effective as the 1.0% concentration in preventing IOP eleva tion immediately after trabeculoplasty, iridotomy, or capsulotomy.