Comparison of Levobunolol and Brimonidine in Prophylaxis of Intraocular Pressure (iop) Rise following Nd:yag Laser Capsulotomy

Objective: To compare the efficacy of topical 0.5% Levobunolol and 0.2% Brimonidine in preventing intraocular pressure rise after Nd: YAG laser posterior capsulotomy. Study Design: Randomized controlled trial (RCT). Setting and Duration of Study: Ophthalmology Department Combined Military Hospital Multan, from September 2010 to March 2011. Patients and Methods: 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 Nd:YAG 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. Results: 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 Nd:YAG laser capsulotomy. The mean intraocular pressure (IOP) one hour after Nd:YAG 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). Conclusion: 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 Nd:YAG laser capsulotomy.