ESCRS - POREF064 - Diluted Brimonidine To Improve Post-Prk And Lasik Symptoms And Subconjunctival Hemorrhage

Diluted Brimonidine To Improve Post-Prk And Lasik Symptoms And Subconjunctival Hemorrhage

Published 2026 - 44th Congress of the ESCRS

Reference: POREF064 | Type: Free paper | DOI: 10.82333/mc3r-ed34

Authors: Dr Bernardo Moscovici* 1 , Dr NATÁLIA NAPOLITANO 2 , Dr ANA VEGA DE FREITAS 2 , Dr EDMUNDO MARTINELLI 2

1Ophthalmology,Unifesp,São Paulo,Brazil, 2Ophthalmology,ABC,Santo André,Brazil

Purpose

To evaluate whether low-concentration brimonidine (0.025%) improves early postoperative signs and symptoms in femtosecond LASIK and PRK without affecting pupil diameter or flap safety.

Setting

Patients seen at the outpatient clinics of Centro Universitário FMABC, who underwent surgery at HOlhos ABC Hospital in São Bernardo do Campo, in the metropolitan region of São Paulo, Brazil

Methods

Prospective, randomized, double-masked, contralateral-eye, single-center study (January–September 2024). In each patient, one eye received 0.025% brimonidine 20 minutes preoperatively, and the fellow eye received 0.15% sodium hyaluronate. Primary day-1 outcomes were subconjunctival hemorrhage (LASIK), and patient-reported symptoms (0–10 scale; composite score). Pupil diameter was recorded pre-ablation. McNemar and paired t-tests were used (α = 0.05).

Results

One hundred twenty-four patients were included (54 LASIK, 70 PRK). Pupil diameter did not differ between treated eyes with brimonidine and control eyes without brimonidine (LASIK: 2.63±0.47 vs 2.69±0.42 mm, p=0.273; PRK: 2.56±0.44 vs 2.61±0.39 mm, p=0.116). In LASIK, subconjunctival hemorrhage was less frequent with brimonidine intraoperatively versus without brimonidine (9.3% vs 46.3%, p<0.001) and on day 1 (9.3% vs 50.0%, p<0.001). Composite symptom scores were lower with brimonidine in both LASIK and PRK (p = 0.001 for both).

Conclusions

Low-concentration brimonidine (0.025%) reduced subconjunctival hemorrhage in LASIK without interfering with flap integrity and was associated with fewer early symptoms in PRK and LASIK without altering pupil diameter. These findings support the use of 0.025% brimonidine as a simple and safe adjunct to improve the immediate postoperative experience in refractive surgery.