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October 1993

Brimonidine in the Prevention of Intraocular Pressure Elevation Following Argon Laser Trabeculoplasty

Author Affiliations

From the Department of Ophthalmology, Soroka University Hospital, Beer-Sheva, Israel (Dr David); Glaucoma Service, Wills Eye Hospital, Philadelphia, Pa (Dr Spaeth); Medical Center Clinic, Pensacola, Fla (Dr Clevenger); Department of Ophthalmology, University of Maryland at Baltimore (Dr Perell); Glaucoma Center of Michigan, Southfield (Dr Siegel); Little Rock (Ark) Eye Clinic (Dr Henry); Hunkler Eye Clinic, Kansas City, Mo (Dr Stiles); Department of Ophthalmology, Oregon Health Sciences University, Portland (Dr Passo); Department of Ophthalmology, California Pacific Medical Center, San Francisco (Dr Stamper); and Department of Ophthalmology Clinical Research, Allergan Inc, Irvine, Calif (Mr Walt and Mss Kelley and Chen). Mr Walt, Ms Kelley, and Ms Chen are employees of Allergan Inc. The other authors have no proprietary interest in either Allergan Inc or its products.

Arch Ophthalmol. 1993;111(10):1387-1390. doi:10.1001/archopht.1993.01090100095034

Objective:  To evaluate the efficacy of 0.5% brimonidine tartrate, an α2-adrenergic agonist, in preventing intraocular pressure (IOP) elevation following argon laser trabeculoplasty.

Design:  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.

Results:  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.

Conclusions:  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.