Comparison of levobunolol and brimonidine in prophylaxis of intraocular pressure [IOP] rise following ndryag laser capsulotomy

ABSTRACT

To compare the efficacy of topical 0.5% Levobunolol and 0.2% Brimonidine in preventing intraocular pressure rise after Nd YAG laser posterior capsulotomy. Randomized controlled trial [RCT]. Ophthalmology Department Combined Military Hospital Multan, from September 2010 to March 2011. A total of 82 patients fulfilling the inclusion criteria were selected from out-patient department and randomly divided into two equal groups. Topical 0.5% levobunolol was instilled in group A while 0.2% brimonidine was instilled in group B one hour before and immediately after doing NdYAG laser capsulotomy. The intraocular pressure [IOP] was measured using Goldmann applanation tonometer 1, 3 and 24 hours later. Data was analyzed using SPSS version 15.0. There was no statistically significant difference in mean IOP between 0.5% Levobunolol group [Group A] and 0.2% Brimonidine group [Group B] at 1 hour, 3 hours and 24 hours after NdYAG laser capsulotomy. The mean intraocular pressure [IOP] one hour after NdYAG laser and topical treatment in group A was 16.10 +/- 1.60 mmHg while in group B was 15.65 +/- 3.01 mmHg [P=0.401]. Mean IOP after three hours in group A was 15.80 +/- 1.35 mm Hg and in group B was 15.05 +/- 2.15 mmHg [p=0.062]. Mean IOP after 24 hours in group A was 15.13 +/- 2.05 mmHg while in group B was 14.32 +/- 1.62 mmHg [p=0.058]. Both 0.5% Levobunolol and 0.2% Brimonidine are equally effective in controlling the IOP spike after Nd yAG laser capsulotomy. Either of these medicines can be used as a prophylaxis to prevent rise in IOP after NdrYAG laser capsulotomy