Abstract

Aim: To evaluate the effect of topical Brimonidine 1% in prevention of intraocular pressure spikes after Nd: YAG laser posterior capsulotomy .
Materials and Methods:
The study was conducted in the outpatient Department of Ophthalmology at GMC Baramulla, over a period of one year from July 2020 to July 2021. It was a prospective, randomized, single blind; placebo controlled study which included post-operative cataract patients with diminished vision, diagnosed as having posterior capsular opacification after uncomplicated cataract surgery and underwent Nd: YAG laser posterior capsulotomy.
190 patients were recruited in our study and divided into two groups of 95 each. Group A received one drop of topical Brimonidine prior to laser and second right after laser. Group B patients received one drop of artificial tears (Lubricant) prior to laser and second right after laser. Follow up was done at one hour , three hours , day one and day three, for intraocular pressure, visual acuity and slit lamp examination .
Results:
In group A, fall in mean IOP was seen at 1 hour, 3 hours, (8% fall in IOP) and mean IOP remained less than the base line at day 1, on the day 3 it approached almost the base line.
 In group B rise in IOP from base line was present in 1 hour, peak of IOP elevation (27.17% rise in IOP) was present at 3 hours .Mean IOP remained almost same at day 1 and started decreasing after that approaching baseline, on day 3, the difference in mean IOP at 1 hour,3 hours and day 1 between 2 groups was statistically significant (P<0.05). IOP reached baseline in both groups at day 3. No ocular systemic side effects were seen in either group.
Conclusion:
 
As the post laser IOP rise generally reached its peak during first 3 hours after laser treatment under ideal circumstances. Any drug used to prevent this complication must reach its maximum effectiveness at the same time. Topical brimonidine reaches near maximum effectiveness 30 minutes after administration. The maximum Intra ocular pressure reduction is attained within two to three hours. Thus prophylactic use of topical brimonidine 1% produces maximum hypotensive effect to coincide with the potential IOP spike.
Effect of prophylactic topical Brimonidine 1% in prevention of intraocular pressure spikes following Nd : YAG laser posterior capsulotomy  in a hospital based study