Chevrier R L, Assalian A, Duperré J, Lesk M R
Department of Ophthalmology, University of Montreal, Quebec, Canada.
Ophthalmic Surg Lasers. 1999 Mar;30(3):199-204.
Both apraclonidine hydrochloride 0.5% and brimonidine tartrate 0.5% are potent alpha-2 agonists, effective in controlling the intraocular pressure (IOP) rise following argon laser trabeculoplasty (ALT). Brimonidine has recently become available commercially as a 0.2% solution. Our goal in this study was to compare the efficacy and side effect profile of 0.2% brimonidine to that of 0.5% apraclonidine in the prevention of IOP spikes following anterior segment laser procedures.
Patients undergoing argon laser trabeculoplasty, Nd:Yag peripheral iridectomy or posterior capsulotomy were prospectively randomized to receive either apraclonidine 0.5% or brimonidine 0.2%, approximately 10 minutes prior to laser surgery. Intraocular pressure was measured by a masked observer, using Goldmann applanation tonometry, before and 1 hour after the treatment.
51 ALTs, 21 peripheral iridectomies, and 13 posterior capsulotomies were performed. The incidence of an IOP rise greater than 5 mmHg was 3/43 (7.0%) in the brimonidine group and 0/42 (0%) in the apraclonidine group (P = 0.08, chi-squared). There were no IOP elevations greater than 8 mmHg. All IOP rises of greater than 5 mmHg occurred in the ALT sub-group, and within this sub-group, the mean change in IOP from pre- to post-op was -4.00 +/- 5.87 in the brimonidine group versus -4.29 +/- 3.86 in the apraclonidine group (P = 0.84). There was a statistically significant decrease in IOP from baseline in both drug groups (P < .0001).
Both drugs are highly effective in controlling IOP spikes following anterior segment laser procedures. There is a tendency toward higher risk of IOP rise following argon laser trabeculoplasty with 0.2% brimonidine as compared to 0.5% apraclonidine, however, this was not statistically significant.
0.5%盐酸阿可乐定和0.5%酒石酸溴莫尼定均为强效α-2激动剂，可有效控制氩激光小梁成形术（ALT）后眼压（IOP）升高。溴莫尼定最近已作为0.2%溶液上市。本研究的目的是比较0.2%溴莫尼定与0.5%阿可乐定在预防眼前节激光手术后IOP峰值方面的疗效和副作用情况。
接受氩激光小梁成形术、钕:钇铝石榴石周边虹膜切除术或后囊切开术的患者在激光手术前约10分钟被前瞻性随机分组，分别接受0.5%阿可乐定或0.2%溴莫尼定。由一位不知情的观察者使用戈德曼压平眼压计在治疗前和治疗后1小时测量眼压。
共进行了51例ALT、21例周边虹膜切除术和13例后囊切开术。溴莫尼定组IOP升高超过5 mmHg的发生率为3/43（7.0%），阿可乐定组为0/42（0%）（P = 0.08，卡方检验）。没有IOP升高超过8 mmHg的情况。所有超过5 mmHg的IOP升高均发生在ALT亚组中，在该亚组内，溴莫尼定组IOP从术前到术后的平均变化为-4.00±5.87，阿可乐定组为-4.29±3.86（P = 0.84）。两个药物组的IOP均较基线有统计学显著下降（P < .0001）。
两种药物在控制眼前节激光手术后的IOP峰值方面均非常有效。与0.5%阿可乐定相比，使用0.2%溴莫尼定进行氩激光小梁成形术后IOP升高的风险有升高趋势，但差异无统计学意义。
