To compare the efficacy and safety of topical 2.0% dorzolamide hydrochloride with oral acetazolamide in preventing intraocular pressure (IOP) rise following neodymium:YAG (Nd:YAG) laser posterior capsulotomy.
A prospective, randomized, double-masked, placebo-controlled study.
Two hundred ten patients undergoing Nd: YAG laser posterior capsulotomy.
Pretreatment with dorzolamide, acetazolamide, or placebo. Dorzolamide administration as a single drop (1 drop≈20 μL) 1 hour before capsulotomy. Acetazolamide administration as a single dose of 125 mg orally 1 hour before capsulotomy.
At first and third hour postoperatively, IOPs and IOP changes from baseline were significantly (P<.001) higher in the placebo group than in the dorzolamide or acetazolamide group. At the same time, IOPs and IOP changes from baseline were similar (P>.50) in the dorzolamide and acetazolamide groups. No patient treated with dorzolamide or acetazolamide experienced an IOP higher than 30 mm Hg after capsulotomy, but 15.7% of patients receiving placebo had an IOP above this level (P<.001). Of patients receiving placebo, 5.7% experienced IOP higher than 35 mm Hg. No serious side effects were recorded in any of the studied patients.
Topical 2.0% dorzolamide and oral acetazolamide, given prophylactically as a single administration 1 hour before Nd:YAG laser posterior capsulotomy, have comparable high efficacy and safety in preventing IOP elevation following this procedure.
Ladas ID, Baltatzis S, Panagiotidis D, Zafirakis P, Kokolakis SN, Theodossiadis GP. Topical 2.0% Dorzolamide vs Oral Acetazolamide for Prevention of Intraocular Pressure Rise After Neodymium:YAG Laser Posterior Capsulotomy. Arch Ophthalmol. 1997;115(10):1241-1244. doi:10.1001/archopht.1997.01100160411003