Effect of intracameral acetylcholine on latanoprost in preventing ocular hypertension after phacoemulsification and intraocular lens implantation

Purpose: To evaluate the effect of intracameral acetylcholine on latanopros t in preventing ocular hypertension in the early period after phacoemulsifi cation with posterior chamber intraocular lens (PC IOL) implantation. Setting: Department of Ophthalmology and Visual Sciences. Prince of Wales H ospital, Shatin, Hong Kong, China. Methods: Patients with uncomplicated cataract having phacoemulsification wi th PC IOL implantation were included in this prospective randomized double- masked clinical trial. The eyes were randomly assigned to 1 of 4 groups bas ed on postoperative application of latanoprost 0.005% alone (Group 1), lata noprost 0.005% with intracameral acetylcholine (Group 2), intracameral acet ylcholine alone (Group 3), and no medication (controls (Group 4). Intraocul ar pressure (IOP) was measured 3 and 24 hours postoperatively. The anterior chamber was examined for the level of cells and flare using slitlamp biomi croscopy. Results: Three and 24 hours after surgery, the decrease in mean IOP in eyes receiving latanoprost alone was not statistically significantly different from that in control eyes (P > .05). Eyes receiving intracameral acetylchol ine alone had a significant decrease in the mean IOP at 3 hours (P (.05) bu t not at 24 hours compared to control eyes (P > .05). There were no signifi cant differences in the mean postoperative IOP decrease between eyes receiv ing latanoprost with intracameral acetylcholine and those receiving intraca meral acetylcholine alone (P > .05). Conclusions A single application of latanoprost did not significantly lower IOP in the first 24 hours after phacoemulsification with PC IOL implantati on. Eyes receiving intracameral acetylcholine alone had a significantly gre ater decrease in IOP than control eyes at 3 hours but not at 24 hours. The addition of intracameral acetylcholine to latanoprost did not enhance or re duce latanoprost's IOP-lowering effect.