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First Author: G.Parkhomenko UKRAINE
Co Author(s): S. Rykov S. Suk N. Obukhova O. Parkhomenko
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To evaluate the rate of intraocular pressure (IOP) elevation after pattern laser trabeculoplasty and its prophylaxis with brimonidin 1,5 mg/ml instillation.
1. Kiev City Clinical Ophthalmological Hospital Eye microsurgery centre, Kiev, Ukraine 2. O. O. Bohomolets National Medical University, Kiev, Ukraine
There were two groups of patients with uncontrolled primary open angle glaucoma included in the study to which Pascal laser trabeculoplasty was performed. Pattern laser trabeculoplasty (360Ḟ) was performed in a single session. The power was tested with single spot coagulate increasing the power until reaching pale slightly visible depigmentation of trabecular meshwork,-then the duration of impulse was decreased by half and treatment was continued with three rows patterns. The first (study) group consisted of 52 eyes to which pattern laser trabeculoplasty (PLT) on Pascal laser system (Topcon) was performed. Each patient received brimonidine 1,5 mg/ml (Alphagan P, Allergan) 30 minutes prior to, immediately before performing and immediately after the laser procedure. The second (control) group consisted of 52 eyes to which PLT was performed without any prophylaxis of reactive IOP elevation. IOP was checked 1 hour, 1, 3, 7, 14 days after laser procedure for a reactive IOP spike. Patients instilled nonsteroid anti-inflammatory drops 4 times daily for 7 days.
The elevation of IOP after Pascal laser trabeculoplasty was observed in1 case (1,9%) in study group and in 3 cases (5,8%) in control group. Reactive IOP spike was associated with patients having heavily pigmented trabecular meshwork.
Prophylaxis of IOP elevation with brimonidine 1,5 mg/ml for Pattern laser trabeculoplasty can reduce the incidence of reactive hypertension by factor 3. It is recommended by the authors that PLT should be considered to be performed in several (two or three) sessionsinpatients with heavily pigmented trabecular meshwork