Hayashi Eye Hospital, Fukuoka, Japan.
Hayashi Eye Hospital, Fukuoka, Japan.
Ophthalmology. 2017 May;124(5):701-708. doi: 10.1016/j.ophtha.2016.12.027. Epub 2017 Jan 19.
To confirm the prophylactic effect of oral acetazolamide against increased intraocular pressure (IOP) in the period immediately after cataract surgery in eyes with primary open-angle glaucoma (POAG) and to evaluate the appropriate administration time of oral acetazolamide to prevent IOP elevation.
Randomized clinical study.
Ninety eyes of 90 patients with well-controlled POAG scheduled for phacoemulsification.
Eyes were assigned randomly to 1 of 3 groups: (1) oral acetazolamide (500 mg) administration 1 hour preoperatively, (2) oral acetazolamide (500 mg) administration 3 hours postoperatively, or (3) no acetazolamide administration. Intraocular pressure was measured using a rebound tonometer 1 hour preoperatively, at the conclusion of surgery (adjusted in the range between 15 and 25 mmHg), and 1, 3, 5, 7, and 24 hours postoperatively. The incidence of eyes with IOP elevation more than 100% above the preoperative IOP was compared.
Postoperative IOP and incidence of eyes with marked IOP elevation.
Mean IOP 1 hour preoperatively and that at the conclusion of surgery did not differ significantly among groups. In all groups, mean IOP was significantly elevated from 3 to 7 hours postoperatively, and then decreased at 24 hours. At 1 and 3 hours postoperatively, mean IOP was significantly lower in the group receiving oral acetazolamide preoperatively than in the other 2 groups (postoperative administration or no administration; P ≤ 0.0031). At 5, 7, and 24 hours postoperatively, the IOP was significantly lower in both the preoperative and postoperative administration groups than in the nonadministration group (P ≤ 0.0224). Intraocular pressure elevation of more than 100% occurred in 1 eye (3.3%) in the preoperative administration group, 7 eyes (23.3%) in the postoperative administration group, and 8 eyes (26.6%) in the nonadministration group; the incidence was significantly lower in the preoperative administration group (P = 0.0459).
Eyes with POAG experienced short-term IOP elevation from 3 to 7 hours after phacoemulsification. Oral acetazolamide administration 1 hour preoperatively significantly reduced the IOP elevation from 1 to 24 hours, while administration 3 hours postoperatively reduced the IOP elevation at 5 hours or more after surgery.
确认口服乙酰唑胺对原发性开角型青光眼（POAG）患者白内障手术后即刻眼压升高的预防作用，并评估口服乙酰唑胺预防眼压升高的最佳给药时间。
随机临床研究。
90 例拟行超声乳化白内障吸除术的 POAG 患者的 90 只眼。
将眼随机分为 3 组：（1）术前 1 小时口服乙酰唑胺（500mg），（2）术后 3 小时口服乙酰唑胺（500mg），或（3）不给予乙酰唑胺。术前 1 小时、手术结束时（调整至 15 至 25mmHg 之间）以及术后 1、3、5、7 和 24 小时使用回弹眼压计测量眼压。比较眼压升高超过术前眼压 100%以上的眼发生率。
术后眼压和眼压升高明显的眼发生率。
术前和手术结束时的平均眼压在各组之间无显著差异。所有组中，术后 3 至 7 小时平均眼压显著升高，24 小时后降低。术后 1 和 3 小时，术前口服乙酰唑胺组的平均眼压明显低于其他 2 组（术后给药或未给药；P≤0.0031）。术后 5、7 和 24 小时，术前和术后给药组的眼压均明显低于未给药组（P≤0.0224）。术前给药组有 1 只眼（3.3%）、术后给药组有 7 只眼（23.3%）和未给药组有 8 只眼（26.6%）眼压升高超过 100%；术前给药组的发生率显著较低（P=0.0459）。
POAG 眼在超声乳化白内障吸除术后 3 至 7 小时经历了短暂的眼压升高。术前 1 小时口服乙酰唑胺可显著降低 1 至 24 小时的眼压升高，而术后 3 小时给药可降低术后 5 小时以上的眼压升高。
