Clinical superiority of either of topical 0.5% apraclonidine, 0.2% brimonidine and 0.03% bimatoprost given prophylactically in managing intraocular pressure spikes following Nd:YAG laser posterior capsulotomy

Abstract

Background: Extracapsular cataract extraction (ECCE) with implantation of posterior chamber intraocular lens (PC IOL) is currently the surgery of choice for cataract, with the success rate of over 95%. Objectives: To earmark clinical superiority of either of the drugs given prophylactically in managing intraocular pressure spikes following Nd:YAG laser posterior capsulotomy. Method: The present study was conducted on 100 patients, who had developed posterior capsule opacification following successful cataract surgery with intraocular lens implantation and underwent Nd:YAG laser posterior capsulotomy in the Outpatient Department of Ophthalmology, RMCH. Results: In Apraclonidine group, pressure differences with control group were evident at 3 hours (ΔP3) & at 24 hours (ΔP24) that were highly statistically significant; (p=0.0078 & 0.0045 for ΔP3 & ΔP24 respectively). The same were not significantly different (p> 0.05) at 1 hour or day 7 following laser application. The Briminodine group demonstrated significant differences in pressure fluctuations compared with control group at all recorded times with maximum variation noted at 3 hours post capsulotomy (p=0.000015). Conclusion: It was concluded Both Apraclonidine & Briminodine are found useful drug interventions in laser therapy, but Briminodine clearly scores over former in dampening the IOP rise.