COMPARISON BETWEEN 0.5% TIMOLOL MALEATE AND 0.2% BRIMONIDINE TARTRATE IN CONTROLLING INCREASE IN INTRAOCULAR PRESSURE AFTER NEODYMIUM: YTTRIUM-ALUMINIUM-GARNET LASER CAPSULOTOMY

Abstract

Objective: To compare the effectiveness of prophylactically given 0.5% Timolol maleate and 0.2% Brimonidine tartrate in controlling increase in intraocular pressure after neodymium (Nd) : yttrium aluminum garnet (YAG) laser capsulotomy.
Study Design: Randomized controlled trial.
Place and Duration of Study: This study was conducted at Ophthalmology Department, Jinnah Hospital, Lahore from 15-05-2009 to 14-05-2010 for a duration of 12 months.
Material and Methods: In this study, 90 consecutive patients were referred from outpatient department for Nd: YAG laser capsulotomy. Hospital ethical committee’s approval for this research proposal and the informed consent was taken. These patients were equally divided into two groups A and B, comprising of 45 patients in each group. Group A was control group which received 0.5% Timolol maleate. Group B was experimental group which received 0.2% Brimonidine tartrate. Intraocular pressure was measured using Goldmann tonometer before instilling these topical medications. These medications were administered topically 1 hour before the laser procedure. Intraocular pressure (IOP) was recorded 1 and 3
hours after laser capsulotomy.
Results: In patients belonging to group A, 42 (93.3%) patients had effective control of IOP (raise of less than or equal to 5 mmHg from the baseline) after 3 hours of Nd:YAG laser capsulotomy whereas 28 (62.2%) patients had effective control of IOP after the same period of time in group-B with significant difference (p<0.001).
Conclusion: Use of prophylactic topical antiglaucoma medications before doing Nd: YAG laser capsulotomy is a effective way to reduce post laser spike of intraocular pressure. Present study showed that the use of 0.5% timolol maleate was safe and more effective than 0.2% brimonidine tartrate when given 1 hour before laser capsulotomy.