Apraclonidine Pretreatment Decreases the Acute Intraocular Pressure Rise After Laser Trabeculoplasty or Iridotomy

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Abstract
Topical treatment with 1% apraclonidine significantly reduced, but did not eliminate, the occurrence of postoperative increases in intraocular pressure (IOP) I h after either argon laser trabeculoplasty or laser iridotomy. IOP before laser trabeculoplasty in the 121 nontreated patients (24.2 ± 0.4 mm Hg) was unchanged (25.6 ± 0.7 mm Hg) 1 h after treatment: 50% of eyes had a pressure less than or equal to the preoperative value, and 17% had pressure that increased ≥ 6 mm Hg, with 12% increasing >10 mm Hg. Prelaser IOP (24.0 ± 0.4 mm Hg) in the 130 eyes receiving apraclonidine before laser trabeculoplasty was significantly reduced (20.8 ± 0.5 mm Hg) 1 h after treatment: 79% of eyes had a pressure less than or equal to the preoperative value, and 6% had a pressure that increased ≥6 mm Hg, with 3% increasing 10 mm Hg. Prelaser pressure (20.6 ± 0.5 mm Hg) in the 115 eyes receiving apraclonidine before laser iridotomy was significantly reduced (18.9 ± 0.6 mm Hg) 1 h after treatment: 71% of eyes had a pressure less than or equal to preoperative value, and 8% had a pressure that increased ≥ 6 mm Hg, with 2% increasing > 10 mm Hg. Postoperative pressure elevations were more frequent when the iridotomy was performed for chronic close-angle glaucoma than when prophylactically performed in an eye with an anatomically narrow iridocorneal angle.

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