Pressão intra-ocular após capsulotomia posterior com laser de Neodymium Yag em olhos pré-tratados com dorzolamida

Minelio, Antonieta Antunes Pereira; Prata Júnior, João Antônio; Abujamra, Suel; Mello, Paulo Augusto de Arruda

doi:10.5935/0004-2749.19980073

RESUMO

Foi analisado o comportamento da pressão intra-ocular em 59 olhos pseudofácicos, submetidos à capsulotomia posterior com laser de Neodymium (Nd): Yag. Foi instilado colírio de dorzolamida 2% imediatamente antes da capsulotomia em 34 olhos (grupo tratado) e outros 25 olhos (grupo controle) não receberam medicação alguma. Na medida de 2 horas a Po do grupo tratado (12,7 ± 4,9 mmHg) foi significativamente inferior à do grupo controle (15,9 ± 5,6 mmHg) (p=0,004). Para as demais medidas não foram observadas diferenças estatisticamente significantes. Após 2 horas, o grupo controle apresentou um aumento percentual médio (Δ%) da Po de 33,4 ± 47,6% e o tratado de 4,6 ± 36,6%, sendo esta diferença estatisticamente significante (p=0,005). Quanto à freqüência de hipertensão≥8 mmHg entre os grupos, não foram observadas diferenças estatisticamente significantes (grupo tratado 17,6% e grupo controle 20%, p=1,0). O uso de dorzolamida 2% tópica proporcionou menores níveis de Po e menor Δ% da Po após capsulotomia com laser de Nd: Yag, sem efeitos adversos.

Palavras-chave:
Hipertensão intra-ocular; Capsulotomia; Nd: Yag laser; Dorzolamida

SUMMARY

Intraocular pressure (Po) was analyzed in 59 pseudophakic eyes that had been submitted to posterior capsulotomy with Nd: Yag-laser. Thirty-four eyes were treated with topical 2% dorzolamide before capsulotomy. Twenty-five eyes did not receive medication (control group). After 2 hours, Po in the treated group (12.7 ± 4. 9 mmHg) was statistically lower than Po of control group (15.9 ± 5. 6 mmHg) (p = 0. 004). There was no statistically significant difference for the other measurements. Controls had an percentual Po increase after 2 hours of 33.4 ± 47.6% and the treated group had an increase of 4.6 ± 36.6%. This difference was statis-tically significant (p = 0.005). There was no statistically significant difference regarding the frequency of hypertension (Po ≥ 8mmHg) (treated group 17.6% and control group 20%) (p = 1.0). Dorzolamide 2% caused lower P o leveis and lower P o increase after the procedure, without adverse effects.

Key words:
intraocular pressure; capsulotomy; Nd: Yag laser; dorzolamide

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REFERÊNCIAS BIBLIOGRÁFICAS

¹
Mello PAA, Prata Junior JA. Capsulotomia Posterior com Nd: Yag Laser em glaucomatosos pseudofácicos. Arq Bras Oftal 1993;56:315-9.
²
Richther CV, Argeno G, Pkappas HP et al. Intraocular pressure elevation following Nd: Yag laser Posterior capsulotomy. Ophthalmology 1985 ;92:636-9.
³
Stark WJ, Worthen D, Holladay JT, Murray G. Yag Laser. An FDA Report. Ophthalmology 1985;92:209-12.
⁴
Gabel VP, Nenbauer L, Zink H, Birngruber R. Ocular side effects following Nd: Yag Laser Irradiation. Int Ophthalmic Clin 1985;25:137.
⁵
Pollack IP, Brown RH, Grandall AS et al. Prevention of the rise in Intraocular pressure following Neodymium: YAG Laser Posterior Capsulotomy. Using topical 1% Apraclonidine. Arch Ophthalmol 1988;106:754-7.
⁶
Brown AH, Stwart R, Lyarch MG, Crandall AS, Mandell AI, Wellesky JT, Shuwortz AL, Gaasterland DE, Defaller JM, Higginbothon EJ. AL.O 2145 redirces the Intraocular pressure elevation after anterior segment laser surgery. Ophthalmology 1988;95:378-83.
⁷
Stilma JS, Boen-Tan TN. Timolol and Intraocular pressure elevation following Neodymium: Yag Laser surgery. Doc Ophthalmol 1986;61:233-9.
⁸
Migliori ME, Beckman H, Channel MN. Intraocular pressure changes after Nd: YAG laser capsulotomy in eyes pretreated with Timolol. Arch Ophthalmol 1987;105:473-5.
⁹
Silverstone DE, Novack GD, Kelley EP & Chen KS. Prophylactic treatment of Intraocular pressure elevations after Nd: YAG Laser Posterior capsulotomies and extracapsular cataract extractions with levobunolol. Ophthalmology 1988;95:713-8.
¹⁰
Arieta CEL, Barbosa KB, Rocha EM, Castro RS, Kara José N. Efeito da pilocarpina 2% na prevenção da elevação da pressão Intraocular pela aplicação de Nd.: Yag laser em capsulotomia Posterior. Arq Bras Oftal 1993;56:266.
¹¹
Ladas ID, Pavlopoulos GP, Kokolakis SN, Theodossiadis GP. Prophylactic use of acetazolamide to prevent Intraocular pressure elevation following Nd: Yag Laser Posterior capsulotomy. Br J Ophthalmol 1993;77:136-8.
¹²
Silverstone DE, Brint SF, Olander KW, Taylor RB, Mc Carty GR, De Faller J M, Burkll. Prophylactic use of apraclonidine for Intraocular pressure increase after Nd: Yag Laser capsulotomies. Am J Ophthalmol 1992;114:377-9.
¹³
Cullom RD Jr., Schwartz LW. The effect of apraclonidine on the Intraocular pressure of glaucoma patients following Nd: Yag Laser Posterior capsulotomy. Opthalmic Surg 1993;24:623-6.
¹⁴
Raspiller A, Berrod JP. Efficacy and tolerability of apraclonidine (ALO 2145, 1%) J. F., in the prevention of early ocular hypertonia, after trabeculoretraction using argon laser and posterior Capsulotomy using Nd: Yag Laser. Ophthalmol 1992;15:651-6.
¹⁵
Lewis RA, Schoenwald RD, Ellen MG, Barfknecht CF, Phelps CD. Ethoxzolamide analogue gel: a topical carbonic anhydrase inhibitor. Arch Ophthalmol 1984;102:1821-4.
¹⁶
Lewis RA, Schoenwald RD, Barfknecht CF, Phelps CD. Aminozolamide gel: a trial of a topical carbonic anhydrase inhibidor in ocular hypertension. Arch Ophthalmol 1986;104:842-4.
¹⁷
Lippa EA Md, PhD e col. Relação dose-resposta e duração da ação da dorzolamida, um inibidor da anidrase carbônica de uso tópico. Arch Ophthalmol 1992; 110:495-9.
¹⁸
Donohue & Wilenski. Trusopt, a topical carbonic anydrase inhibitor. J Glaucoma 1996;5:69-74.

Datas de Publicação

Publicação nesta coleção
Apr 1998

Este é um artigo publicado em acesso aberto (Open Access) sob a licença Creative Commons Attribution, que permite uso, distribuição e reprodução em qualquer meio, sem restrições desde que o trabalho original seja corretamente citado.

[1] ¹
Mello PAA, Prata Junior JA. Capsulotomia Posterior com Nd: Yag Laser em glaucomatosos pseudofácicos. Arq Bras Oftal 1993;56:315-9.

[2] ²
Richther CV, Argeno G, Pkappas HP et al. Intraocular pressure elevation following Nd: Yag laser Posterior capsulotomy. Ophthalmology 1985 ;92:636-9.

[3] ³
Stark WJ, Worthen D, Holladay JT, Murray G. Yag Laser. An FDA Report. Ophthalmology 1985;92:209-12.

[4] ⁴
Gabel VP, Nenbauer L, Zink H, Birngruber R. Ocular side effects following Nd: Yag Laser Irradiation. Int Ophthalmic Clin 1985;25:137.

[5] ⁵
Pollack IP, Brown RH, Grandall AS et al. Prevention of the rise in Intraocular pressure following Neodymium: YAG Laser Posterior Capsulotomy. Using topical 1% Apraclonidine. Arch Ophthalmol 1988;106:754-7.

[6] ⁶
Brown AH, Stwart R, Lyarch MG, Crandall AS, Mandell AI, Wellesky JT, Shuwortz AL, Gaasterland DE, Defaller JM, Higginbothon EJ. AL.O 2145 redirces the Intraocular pressure elevation after anterior segment laser surgery. Ophthalmology 1988;95:378-83.

[7] ⁷
Stilma JS, Boen-Tan TN. Timolol and Intraocular pressure elevation following Neodymium: Yag Laser surgery. Doc Ophthalmol 1986;61:233-9.

[8] ⁸
Migliori ME, Beckman H, Channel MN. Intraocular pressure changes after Nd: YAG laser capsulotomy in eyes pretreated with Timolol. Arch Ophthalmol 1987;105:473-5.

[9] ⁹
Silverstone DE, Novack GD, Kelley EP & Chen KS. Prophylactic treatment of Intraocular pressure elevations after Nd: YAG Laser Posterior capsulotomies and extracapsular cataract extractions with levobunolol. Ophthalmology 1988;95:713-8.

[10] ¹⁰
Arieta CEL, Barbosa KB, Rocha EM, Castro RS, Kara José N. Efeito da pilocarpina 2% na prevenção da elevação da pressão Intraocular pela aplicação de Nd.: Yag laser em capsulotomia Posterior. Arq Bras Oftal 1993;56:266.

[11] ¹¹
Ladas ID, Pavlopoulos GP, Kokolakis SN, Theodossiadis GP. Prophylactic use of acetazolamide to prevent Intraocular pressure elevation following Nd: Yag Laser Posterior capsulotomy. Br J Ophthalmol 1993;77:136-8.

[12] ¹²
Silverstone DE, Brint SF, Olander KW, Taylor RB, Mc Carty GR, De Faller J M, Burkll. Prophylactic use of apraclonidine for Intraocular pressure increase after Nd: Yag Laser capsulotomies. Am J Ophthalmol 1992;114:377-9.

[13] ¹³
Cullom RD Jr., Schwartz LW. The effect of apraclonidine on the Intraocular pressure of glaucoma patients following Nd: Yag Laser Posterior capsulotomy. Opthalmic Surg 1993;24:623-6.

[14] ¹⁴
Raspiller A, Berrod JP. Efficacy and tolerability of apraclonidine (ALO 2145, 1%) J. F., in the prevention of early ocular hypertonia, after trabeculoretraction using argon laser and posterior Capsulotomy using Nd: Yag Laser. Ophthalmol 1992;15:651-6.

[15] ¹⁵
Lewis RA, Schoenwald RD, Ellen MG, Barfknecht CF, Phelps CD. Ethoxzolamide analogue gel: a topical carbonic anhydrase inhibitor. Arch Ophthalmol 1984;102:1821-4.

[16] ¹⁶
Lewis RA, Schoenwald RD, Barfknecht CF, Phelps CD. Aminozolamide gel: a trial of a topical carbonic anhydrase inhibidor in ocular hypertension. Arch Ophthalmol 1986;104:842-4.

[17] ¹⁷
Lippa EA Md, PhD e col. Relação dose-resposta e duração da ação da dorzolamida, um inibidor da anidrase carbônica de uso tópico. Arch Ophthalmol 1992; 110:495-9.

[18] ¹⁸
Donohue & Wilenski. Trusopt, a topical carbonic anydrase inhibitor. J Glaucoma 1996;5:69-74.

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