Control of intraocular pressure elevations after argon laser trabeculoplasty

Objective: To determine whether brimonidine 0.2% can control intraocular pressure (IOP) spikes as well as apraclonidine 1.0% can in those patients undergoing argon laser trabeculoplasty (ALT), Design: Prospective, randomized, double-masked, clinical trial. Participants: A total of 56 eyes of 41 patients with open-angle glaucoma or ocular hypertension were entered in the study; 46 eyes of 41 patients were eventually used for the final analysis, Intervention: Patients were randomized to receive either brimonidine 0.2% or apraclonidine 1.0% before and after 360 degrees ALT, Both patient and physician were masked as to which agent each patient received. Main Outcome Measures: Intraocular pressure measurements were recorded before surgery and at 1, 2, and 4 hours after surgery. The difference between the preoperative IOP (baseline) and the highest recorded postoperative IOP was recorded as the maximum IOP change. The mean of the maximum IOP change for each group was analyzed using a two-sample, one-tailed t test. Results: The mean of the maximum IOP change in the brimonidine 0.2% group was -2.6 +/- 3.6 mmHg, and the mean for the apraclonidine 1.0% group was -2.3 +/- 3.7 mmHg (P = 0.8). No patient had a pressure spike greater than 10 mmHg. Conclusions: Brimonidine 0.2% appears to be as effective as apraclonidine 1.0% in preventing IOP spikes after argon laser tuabeculoplasty.