Simsek S, Ertürk H, Demirok A, Cinal A, Yasar T, Karadenizli C
Department of Ophthalmology Medical Faculty, Yüzüncü Yil University, Van, Turkey.
Eur J Ophthalmol. 1998 Jul-Sep;8(3):167-72. doi: 10.1177/112067219800800309.
The efficacy and adverse effects of 0.25% apraclonidine on intraocular pressure (IOP) after Nd:YAG laser posterior capsulotomy were investigated, and the results were compared with placebo, 0.50% timolol maleate and 1% apraclonidine.
Eighty eyes were randomly assigned to four groups of 20 eyes. In a double-masked design, the groups were treated with placebo (group 1), 0.50% timolol maleate (group 2), 1% apraclonidine (group 3), 0.25% apraclonidine (group 4) one hour before and five minutes after Nd:YAG laser posterior capsulotomy. IOP was measured by applanation tonometry 1 hour before (baseline IOP) and 1, 3, 24 hours after capsulotomy.
The average baseline IOP increased respectively 3.90 +/- 5.35, 5.95 +/- 5.32, 1.15 +/- 3.20 mmHg in the first group 1, 3 and 24 hours post-treatment. There were significant differences between baseline IOP and 1 and 3 hours but not at 24 hours (p = 0.004, p = 0.001, p = 0.13). IOP increased 0.40 +/- 4.08, 0.75 +/- 5.33, 0.80 +/- 6.03 mmHg in the second group at the same times. The differences between the average baseline IOP and the 1, 3 and 24 h measurement were not significant (p = 0.83, p = 0.65, p = 0.93). In the third group, IOP decreased 3.70 +/- 2.40, 3.30 +/- 2.47, 2.65 +/- 1.56 mmHg at the measurement times, with significant differences between the average baseline IOP and the 1, 3 and 24 hour measurements (p = 0.001, p = 0.0001, p = 0.01). In the fourth group IOP increased 0.35 +/- 3.32 mmHg at 1 hour, but decreased 1.25 +/- 3.41, 0.90 +/- 2.07 mmHg at 3 and 24 hours. The differences were not significant (p = 0.94, p = 0.16, p = 0.08). When the 0.25% and 1% apraclonidine groups were compared, there were significant differences between the average IOP at 1 hour in both groups but not at 3 and 24 hours (p = 0.01, p = 0.17, p = 0.21). Similarly, there were no significant differences between the average IOP at the same times when the 0.25% apraclonidine group was compared with the timolol group (p = 0.30, p = 0.08, p = 0.16). Some systemic and local side effects were seen in the timolol and 1% apraclonidine groups, but none with 0.25% apraclonidine.
It was concluded that 0.25% apraclonidine is effective in preventing the early elevation of IOP after Nd:YAG laser posterior capsulotomy and may offer an alternative to 0.50% timolol maleate and 1% apraclonidine.
研究0.25%阿可乐定对钕:钇铝石榴石激光后囊切开术后眼压（IOP）的疗效及不良反应，并将结果与安慰剂、0.50%马来酸噻吗洛尔和1%阿可乐定进行比较。
80只眼随机分为4组，每组20只眼。采用双盲设计，在钕:钇铝石榴石激光后囊切开术前1小时及术后5分钟，分别用安慰剂（第1组）、0.50%马来酸噻吗洛尔（第2组）、1%阿可乐定（第3组）、0.25%阿可乐定（第4组）进行治疗。分别于切开术前1小时（基线眼压）及切开术后1、3、24小时采用压平眼压计测量眼压。
第1组治疗后1、3、24小时平均基线眼压分别升高3.90±5.35、5.95±5.32、1.15±3.20 mmHg。基线眼压与1、3小时时相比有显著差异，但与24小时时相比无显著差异（p = 0.004，p = 0.001，p = 0.13）。第2组在相同时间眼压分别升高0.40±4.08、0.75±5.33、0.80±6.03 mmHg。平均基线眼压与1、3、24小时测量值之间的差异无统计学意义（p = 0.83，p = 0.65，p = 0.93）。第3组在测量时眼压分别降低3.70±2.40、3.30±2.47、2.65±1.56 mmHg，平均基线眼压与1、3、24小时测量值之间有显著差异（p = 0.001，p = 0.0001，p = 0.01）。第4组在1小时时眼压升高0.35±3.32 mmHg，但在3小时和24小时时分别降低1.25±..41、0. ..07 mmHg。差异无统计学意义（p = 0.94，p = 0.16，p = 0.08）。当比较0.25%和1%阿可乐定组时，两组1小时时的平均眼压有显著差异，但3小时和24小时时无显著差异（p = 0.01，p =...，p =...）)。同样，0.25%阿可乐定组与噻吗洛尔组在相同时间的平均眼压无显著差异（p = 0.30，p = 0.08，p = 0.16）。在噻吗洛尔组和1%阿可乐定组中观察到一些全身和局部副作用，但0.25%阿可乐定组未出现。
得出结论，0.25%阿可乐定可有效预防钕:钇铝石榴石激光后囊切开术后早期眼压升高，可能是0.50%马来酸噻吗洛尔和1%阿可乐定的替代药物。
