Sterk C C, Renzenbrink-Bubberman A C, van Best J A
Department of Ophthalmology, Leiden University Medical Center, The Netherlands.
Ophthalmic Surg Lasers. 1998 Jun;29(6):472-5.
To measure the effect of 1% apraclonidine hydrochloride eyedrops on intraocular pressure (IOP) after cataract surgery. The effects of two different dosage regimens, once before surgery or once before and after surgery, were studied.
Patients scheduled for extracapsular cataract extraction and artificial lens implantation were randomly assigned to three groups: group A had a placebo treatment (n = 18), group B had one drop of 1% apraclonidine 1 hour before surgery (n = 16), and group C had one drop of 1% apraclonidine 1 hour before surgery and 1 drop at the end of surgery (n = 17). Two percent hydroxy-propyl-methyl-cellulose was used as the viscoelastic substance. The preoperative IOP and the IOP 6 hours postoperatively in each patient were compared. The paired Student's t test was used to compare IOP before and after surgery. The study design was a randomly assigned, double-masked controlled clinical trial.
In group A (placebo) and group B (apraclonidine before surgery), there was a significant increase in IOP (mean IOP increase 11.2 +/- 9.9 mm Hg SD, range -4 to 32, P = .00017, and 9.4 +/- 7.4 mm Hg SD, range -3 to 24, P = .00014, respectively). In group C (apraclonidine 1 hour before and immediately after surgery), the increase in IOP was not significant (mean IOP increase 5.1 +/- 11.5 mm Hg SD, range -10 to 28, P = .084). A postoperative IOP of more than 40 mm Hg applanation tension was reached by two patients in group A, one patient in group B, and two patients in group C.
Although 1% apraclonidine eye-drops instilled 1 hour before and immediately after extracapsular cataract extraction with artificial lens implantation may help prevent a statistically significant increase in IOP after the operation, 2 of the 17 patients still had IOPs greater than 40 mm Hg 6 hours postoperatively. Apraclonidine applied only before surgery did not prevent a statistically significant increase in IOP.
测量1%盐酸阿可乐定滴眼液对白内障手术后眼压（IOP）的影响。研究了两种不同给药方案（术前一次或术前及术后各一次）的效果。
计划行白内障囊外摘除术及人工晶状体植入术的患者被随机分为三组：A组接受安慰剂治疗（n = 18），B组在手术前1小时滴入一滴1%阿可乐定（n = 16），C组在手术前1小时和手术结束时各滴入一滴1%阿可乐定（n = 17）。使用2%羟丙基甲基纤维素作为粘弹剂。比较每位患者术前眼压和术后6小时眼压。采用配对t检验比较手术前后眼压。本研究设计为随机分组、双盲对照临床试验。
A组（安慰剂组）和B组（术前使用阿可乐定组）眼压显著升高（平均眼压升高分别为11.2±9.9 mmHg标准差，范围-4至32，P = 0.00017；9.4±7.4 mmHg标准差，范围-3至24，P = 0.00014）。C组（术前1小时及术后即刻使用阿可乐定组）眼压升高不显著（平均眼压升高5.1±11.5 mmHg标准差，范围-10至28，P = 0.084）。A组有2例患者、B组有1例患者、C组有2例患者术后眼压达到40 mmHg以上的压平眼压。
尽管在白内障囊外摘除联合人工晶状体植入术前1小时及术后即刻滴入1%阿可乐定滴眼液可能有助于防止术后眼压出现统计学意义上的显著升高，但17例患者中有2例术后6小时眼压仍高于40 mmHg。仅在术前使用阿可乐定不能防止眼压出现统计学意义上的显著升高。
