Pilocarpine to prevent acute pressure increase following primary laser trabeculoplasty.

The effect of pilocarpine pretreatment on the transient pressure elevations immediately following primary laser trabeculoplasty was investigated in a prospective, randomised study. Fifty eyes of 50 patients, 33 with exfoliative and 17 with simple glaucoma, were treated in 360 degrees of the trabecular meshwork. The mean maximum pressure increase was 2.4 (SD = 4.4)mm Hg with pilocarpine pretreatment and 12.8 (SD = 11.2)mm Hg without pretreatment (p less than 0.05). Except in two cases, all peak pressures appeared during the first two hours after treatment. The degree of chamber angle pigmentation was predictive of the magnitude of the post laser hypertensive pressure response in eyes without pretreatment (p less than 0.05).