Document Detail

Neodymium:yttrium-aluminum-garnet capsulotomy and intraocular pressure in pseudophakic patients with glaucoma.
MedLine Citation:
PMID:  15234143     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine the 1- and 3-hour changes in intraocular pressure after neodymium:yttrium-aluminum-garnet (Nd:YAG) capsulotomy in pseudophakic patients with glaucoma and to determine the effect of acetazolamide and apraclonidine on these changes. DESIGN: Randomized controlled trial. PARTICIPANTS: Pseudophakic patients with glaucoma requiring Nd:YAG posterior capsulotomy (n = 76). INTERVENTION: Patients undergoing Nd:YAG posterior capsulotomy were randomly allocated to receive no therapy, oral acetazolamide (250 mg), or topical apraclonidine 1% within 1 hour before capsulotomy. MAIN OUTCOME MEASURES: Intraocular pressures 1 and 3 hours after laser therapy were recorded. RESULTS: Data were available for 76 eyes in 76 patients. Twenty-nine patients received no therapy; 24, oral acetazolamide; and 23, apraclonidine. One fifth (6/29) of patients with glaucoma developed a pressure rise of > or =5 mmHg if untreated, and 3% (1/29) developed a pressure rise of >10 mmHg. In comparison, no patients in the acetazolamide group developed a pressure rise of > or =5 mmHg (P = 0.02), and 1 of 24 in the apraclonidine group (P = 0.08) developed such a pressure rise, with none developing a pressure rise of >10 mmHg. When comparing all treated with nontreated, a reduction in the proportion with pressure rise was found (P = 0.01). All of the patients who developed a pressure rise of > or =5 mmHg did so within the first hour. CONCLUSIONS: In the absence of therapy, clinically significant post-Nd:YAG pressure rises occur in one fifth of patients with glaucoma undergoing capsulotomy. Oral acetazolamide and topical apraclonidine reduce the frequency and magnitude of pressure rises and are of comparable effectiveness. In this study, all clinically important pressure rises developed within the first hour.
Eric A Barnes; Ian E Murdoch; Srinivasan Subramaniam; Angela Cahill; Brenda Kehoe; Michael Behrend
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Ophthalmology     Volume:  111     ISSN:  0161-6420     ISO Abbreviation:  Ophthalmology     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-07-05     Completed Date:  2004-07-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7802443     Medline TA:  Ophthalmology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1393-7     Citation Subset:  IM    
Moorfields Eye Hospital, London, United Kingdom.
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MeSH Terms
Acetazolamide / therapeutic use
Administration, Oral
Administration, Topical
Adrenergic alpha-Agonists / therapeutic use
Antihypertensive Agents / therapeutic use*
Carbonic Anhydrase Inhibitors / therapeutic use
Clonidine / analogs & derivatives*,  therapeutic use
Double-Blind Method
Glaucoma / complications*
Intraocular Pressure / drug effects*
Laser Therapy*
Lens Capsule, Crystalline / surgery*
Postoperative Complications / prevention & control
Prospective Studies
Pseudophakia / complications*
Reg. No./Substance:
0/Adrenergic alpha-Agonists; 0/Antihypertensive Agents; 0/Carbonic Anhydrase Inhibitors; 4205-90-7/Clonidine; 59-66-5/Acetazolamide; 66711-21-5/apraclonidine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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