The Science behind the Tip
IOP spikes, i.e. an IOP elevation after surgery compared to baseline, often occur in eyes with glaucoma.2 IOP spikes may lead to further progression of glaucomatous damage.http://3-6 Prior studies assessed the prophylactic effect of oral acetazolamide. In a recently published randomized trial eyes with medically well-controlled primary open-angle and pseudoexfoliative glaucoma which were scheduled for phacoemulsification were assigned to receive the following topical hypotensive medications immediately after surgery: (1) prostaglandin (travoprost 0.004%, Travatanz; Novartis Pharma K.K., Tokyo, Japan), (2) beta blocker (timolol maleate 0.5%, Timoptol; Santen Pharmaceutical, Tokyo, Japan), or (3) carbonic anhydrase inhibitor (brinzolamide, Azopt; Novartis Pharma K.K.).http://7 All antihypertensive topical medications were discontinued the day before surgery and one of the previous mentioned medications was applied immediately after surgery. Mean IOP increased significantly between 4 and 8 hours postoperatively and then decreased at 24 hours postoperatively. Mean IOP increased significantly between 4 and 8 hours postoperatively and then decreased at 24 hours postoperatively in all groups (P < .0001). Mean IOP was significantly lower in the brinzolamide group. Given the results, topical brinzolamide may be beneficial to prevent IOP spikes in eyes with glaucoma after cataract surgery.
Contributor: Marc Töteberg-Harms, Zurich
References
Tip Reviewer: Roger Hitchings
Tip Editors: Frances Meier-Gibbons, Humma Shahid, Karl Mercieca, Francisco Goni