THE EFFICACY OF BRIMONIDINE IN DECREASING ELEVATIONS IN INTRAOCULAR-PRESSURE AFTER LASER TRABECULOPLASTY

Purpose: The authors explored the empirical dosing requirement for adm inistration of an alpha2-adrenoceptor agonist, brimonidine, and determ ined its efficacy in decreasing elevations in intraocular pressure (IO P) after 360-degrees argon laser trabeculoplasty (ALT). Methods: This vehicle-controlled, double-masked, multicenter trial evaluated three d osing regimens of brimonidine. Two hundred thirty-two patients for who m 3600 ALT was indicated were randomized into one of four treatment gr oups: 0.5% brimonidine both before and after ALT; brimonidine before b ut vehicle after ALT; vehicle before but brimonidine after ALT; or veh icle at both times. Results: During the first 3 hours after 360-degree s ALT, the overall incidence of IOP elevations of 5 mmHg or greater wa s 38% (23 of 60 eyes) in the group receiving vehicle only, and it rang ed from 3% to 9% (2 of 62 to 5 of 53 eyes) in the groups receiving any brimonidine treatment. There was little difference in efficacy betwee n the three dosing regimens of brimonidine. Brimonidine was well toler ated by the patients. Conclusion: Based on this large, controlled, mul ticenter study, 0.5% brimonidine was an effective agent for reducing e levations in IOP after 360-degrees ALT. Only one dose, administered ei ther before or after 360-degrees ALT, was required.