Fixed combination brimonidine-timolol versus brimonidine for treatment of intraocular pressure elevation after neodymium: YAG laser posterior capsulotomy

Abstract

Purpose: To evaluate the efficacy of fixed combination brimonidine-timolol (FCBT) in comparison with brimonidine tartrate 0.2% and control for the treatment of intraocular pressure (IOP) spikes after neodymium:YAG (Nd:YAG) laser posterior capsulotomy. Methods: One hundred five eyes of 105 patients were enrolled in the study. Patients were randomized to 3 groups (each group, including 35 patients): the FCBT group that received 1 drop of FCBT, the brimonidine group that received 1 drop of brimonidine tartrate 0.2%, and the control group that received 1 drop of artificial tear, 1 h before the laser procedure. Postoperative IOP measurements were performed at 1st, 2nd, 3rd, 24th hours, and seventh day. Results: the mean IOP changes from baseline were statistically different between the study groups at first, second, and third hours (all P < 0.001). Pairwise comparisons showed that although the mean IOP changes of the treatment groups were similar at 1st and 24th hours and seventh day (all P > 0.05), the IOP levels of the brimonidine group were less reduced from baseline than the FCBT group at second and third hours (P = 0.01 and P = 0.03, respectively). the differences among the study groups concerning the incidence of IOP elevations of >= 5 or >= 10 mmHg were statistically significant (P = 0.007, P = 0.04, respectively). However, the differences between the treatment groups were not statistically significant (both P > 0.05). Conclusion: This study has shown that preoperative instillation of 1-drop FCBT was safe and effective for preventing IOP spikes after Nd: YAG laser posterior capsulotomy. FCBT may be a better option than brimonidine tartrate 0.2%, which is one of the current standard prophylaxes for these spikes.