To evaluate the efficacy of 0.5% brimonidine tartrate, an α2-adrenergic agonist, in preventing intraocular pressure (IOP) elevation following argon laser trabeculoplasty.
In a multicenter, double-masked, randomized study, 248 patients (248 eyes) who underwent argon laser trabeculoplasty were allocated to four treatment groups: (1) brimonidine administered before and after the procedure; (2) brimonidine administered before the procedure; (3) brimonidine administered after the procedure; and (4) a vehicle administered before and after the procedure.
In the first 3 hours after argon laser trabeculoplasty, only one (0.54%) of the 183 brimonidine-treated patients had a postlaser IOP increase of 10 mm Hg or more, while increases of this magnitude occurred in 13 (23%) of the 56 patients who received only the vehicle (P<.001). The three brimonidine-treatment groups demonstrated significant mean reductions in IOP from the pretrabeculoplasty level (−4 to −8 mm Hg), whereas the vehicle-treated group showed an increase in mean IOP (4 mm Hg). Side effects associated with brimonidine treatment included conjunctival blanching (40.9%), lid retraction (7.6%), and a slight lowering of the systolic blood pressure.
One drop of 0.5% brimonidine administered either before or after surgery was found to be efficacious and safe in preventing posttrabeculoplasty elevations in IOP.
David R, Spaeth GL, Clevenger CE, Perell HF, Siegel LI, Henry JC, Stiles MC, Passo MS, Stamper RL, Walt JG, Kelley EP, Chen KS. Brimonidine in the Prevention of Intraocular Pressure Elevation Following Argon Laser Trabeculoplasty. Arch Ophthalmol. 1993;111(10):1387-1390. doi:10.1001/archopht.1993.01090100095034