Hill R A, Minckler D S, Lee M, Heuer D K, Baerveldt G, Martone J F
Department of Ophthalmology, University of California, College of Medicine, Irvine 92717.
Ophthalmology. 1991 Jul;98(7):1083-6. doi: 10.1016/s0161-6420(91)32188-2.
A randomized, prospective, double-masked study was undertaken to determine the risk of postcycloplegic intraocular pressure spikes in patients with open-angle glaucoma and to evaluate apraclonidine prophylaxis in minimizing these spikes. Patients were stratified as miotic treated or untreated and each group was randomized to receive either placebo (artificial tears) or apraclonidine in both eyes before instillation of tropicamide. In both the miotic treated and untreated groups that received placebo, there was a high incidence, (37% and 38%, respectively) of clinically significant (greater than or equal to 6 mmHg) intraocular pressure spikes after instillation of tropicamide. In both the miotic treated and untreated groups, there was a statistically significant difference in postcycloplegic intraocular pressure between the subgroup that received placebo and the group that received apraclonidine prophylaxis (P = 0.003 and P = 0.006, respectively). Additionally, four eyes that received placebo had a spike of over 10 mmHg (range, 12 to 27 mmHg), while only one eye had an increase of greater than 10 mmHg (12 mmHg) in the apraclonidine group. Thus, apraclonidine appears to be a useful agent for minimizing precipitous increases in intraocular pressure after cycloplegia in eyes of open-angle glaucoma patients prone to this complication of cycloplegia.
开展了一项随机、前瞻性、双盲研究，以确定开角型青光眼患者在使用睫状肌麻痹剂后眼压急剧升高的风险，并评估阿可乐定预防措施对降低这些眼压急剧升高情况的效果。患者被分为接受缩瞳剂治疗组和未治疗组，每组在滴入托吡卡胺之前，随机双眼分别接受安慰剂（人工泪液）或阿可乐定。在接受安慰剂的缩瞳剂治疗组和未治疗组中，滴入托吡卡胺后临床上显著（大于或等于6 mmHg）的眼压急剧升高发生率都很高（分别为37%和38%）。在缩瞳剂治疗组和未治疗组中，接受安慰剂的亚组与接受阿可乐定预防措施的组之间，睫状肌麻痹剂后眼压存在统计学上的显著差异（分别为P = 0.003和P = 0.006）。此外，接受安慰剂的4只眼眼压升高超过10 mmHg（范围为12至27 mmHg），而在阿可乐定组中只有1只眼眼压升高超过10 mmHg（12 mmHg）。因此，对于易出现睫状肌麻痹这种并发症的开角型青光眼患者，阿可乐定似乎是一种有助于将睫状肌麻痹后眼压急剧升高降至最低的药物。
