PURPOSE: To analyze and compare the effects on intraocular pressure (IOP) of several topic hypotensive agents after posterior capsulotomy with Nd:YAG laser in non glaucoma patients. METHODS: 145 pseudophakic eyes underwent to Nd:YAG laser posterior capsulotomy. Before capsulotomy. 21 were treated with apraclonidine, 20 with brimonidine, 23 with dorzolamide, 20 with latanoprost, 20 with pilocarpine, and 20 with timolol. Controls (21 eyes) received placebo. IOP measurements (Goldmann applanation tonometry) were taken under masked conditions 1 hour before procedure and after 1 and 2 hours. If postoperative PIO was above 20 mmHg its measurements were extended to 4 and 24 hours. Capsulotomy was performed with Abraham lens, under topic anesthetic, using Nd:YAG laser. Ocular hypertension would be considered if the IOP had suffered an increase of 4 mmHg above the initial. Mean total energy used was 2.1 ± 1 mJ. RESULTS: The preoperative IOP did not differ statistically among groups. Mean IOPs of treated eyes 1h (11.9 ± 3.8) and 2h (11.5 ± 3.0) were statistically lower than IOP compared with control group (12,6 ± 2,8) (p=0.001). There were no statistically significant differences for the other measurements. Control and pilocarpine had a percentual IOP increase after 2 hours of 8.7 ± 19.1% (13.5 ± 3.2 mmHg) and 1.2 ± 26.3% (12.5 ± 3.6 mmHg) respectively. Mean percentual postoperative IOP reduction was detected in the apraclonidine group -24.7 ± 15.5% (9.8 ± 2.6 mmHg), in the brimonidine group -8.9 ± 15.5% (10.1 ± 1.7 mmHg), in the dorzolamide group -6.9 ± 20.3% (12.1 ± 2.8 mmHg), in the latanoprost group -0.4 ± 25.9% (12.1 ± 2.9 mmHg) and in timolol group -16.2 ± 14.1% (10.3 ± 1.7 mmHg). These differences were statistically significant (p=0.001). There was no significant difference between frequencies of hypertension (p=0.148). CONCLUSION: Apraclonidine caused higher hypotensive effect after capsulotomy with YAG laser when compared with brimonidine, dorzolamide, latanoprost, pilocarpine, timolol and control group.
Ocular hypertension; Lens capsule, crystalline; Lasers; Antihypertensive agents
