| Neodymium:yttrium-aluminum-garnet capsulotomy and intraocular pressure in pseudophakic patients with glaucoma. | |
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MedLine Citation:
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PMID: 15234143 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Eric A Barnes; Ian E Murdoch; Srinivasan Subramaniam; Angela Cahill; Brenda Kehoe; Michael Behrend |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Ophthalmology Volume: 111 ISSN: 0161-6420 ISO Abbreviation: Ophthalmology Publication Date: 2004 Jul |
Date Detail:
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Created Date: 2004-07-05 Completed Date: 2004-07-27 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7802443 Medline TA: Ophthalmology Country: United States |
Other Details:
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Languages: eng Pagination: 1393-7 Citation Subset: IM |
Affiliation:
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Moorfields Eye Hospital, London, United Kingdom. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acetazolamide
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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* Humans Intraocular Pressure / drug effects* Laser Therapy* Lens Capsule, Crystalline / surgery* Phacoemulsification Postoperative Complications / prevention & control Prospective Studies Pseudophakia / complications* |
| Chemical | |
Reg. No./Substance:
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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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