Prevention of early postoperative increase in intraocular pressure after phacoemulsification

Purpose. To compare the ocular hypotensive effect of different antiglaucoma tous eye drops. Patients and methods. This double-blind, randomized study included 119 eyes of 119 patients without other ocular pathology undergoing standardized (on e surgeon, Healon) small incision cataract surgery with foldable intraocula r lens implantation. The patients were assigned to one of five groups: grou p 1:0.25% timolol in Gelrite (extended efficacy, n=23);group 2:2% dorzolami de (n=24); group 3: combination of 0.5% timolol plus 2% dorzolamide (n=22); group 4: brimonidine (n=26); group 5: gentamicin (control, n=24). Intraocu lar pressure (IOP) was measured preoperatively and at 3 +/-1, 6 +/-1, 9 +/- 1, 24 +/-3, and 48 +/-3 h postoperatively. Statistical interference was det ermined by nonparametric group comparisons using Wilcoxon's tests. Absolute values (static comparison) and intraindividual differences from preoperati ve measurements (dynamic comparisons) were evaluated. All p values should b e regarded as descriptive values since they were not formally adjusted for multiplicity. A p value lower than 0.05 therefore indicates local statistic al significance. Results. There were no differences between the groups with regard to age, p hacoemulsification time, axial length,and preoperative IOP. A statistically significant IOP decrease was measured in group 1 at 24 (p=0.028) and 48 h (p=0.007) and in group 3 at 3 (p=0.001), 6 (p=0.001), 24 (p=0.001),and 48 h (p=0.001) after surgery. A statistically significant IOP increase occurred in group 4 at 3 (p=0.001), 6 (p=0.001), and 9 h (p=0.001) and in group 5 a t 3 (p=0.001), 6 (p=0.001), 9 (p=0.001), and 24 h (p=0.002) postoperatively . Groups 1, 2, and 3 demonstrated lower IOPs at different time points in co mparison to groups 4 and 5. Furthermore, group 3 had lower IOPs at 3 h (com pared to group 1) and at 6 h (compared to group 2) postoperatively. No stat istical differences in IOP were found after 48 h. Conclusion. The results favor a combination of 0.5% timolol plus 2% dorzola mide to control postoperative IOP elevation.