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Abstract #6469 Published in IGR 3-2
The adverse effect of perioperative brimonidine tartrate 0.2% on flap adherence and enhancement rates in laser in situ keratomileusis patients
Walter KA; Gilbert DDOphthalmology 2001; 108: 1434-1438
PURPOSE: To investigate the effect of perioperative brimonidine tartrate 0.2% on postoperative flap adherence and enhancement rates in patients undergoing laser in situ keratomileusis (LASIK). DESIGN: A noncomparative interventional case series. PARTICIPANTS: Records of 279 eyes of 144 consecutive patients who underwent LASIK between June 17th, 1999, and March 1st, 2000, were reviewed retrospectively. METHODS: From September 28th to November 4th, 1999, 39 eyes of 20 consecutive patients had a single drop of brimonidine tartrate 0.2% instilled into their operative eye(s) before LASIK. This group was interposed in time between two nonbrimonidine groups, one before the use of brimonidine, 'prior nonbrimonidine group' (107 eyes of 56 patients), and one after the use of brimonidine, 'post nonbrimonidine group' (133 eyes of 68 patients). All 279 eyes in the study were examined after surgery to identify flap folds and dislocations. Enhancement rates and visual outcomes for the brimonidine and nonbrimonidine groups were also documented. MAIN OUTCOME MEASURES: Comparison of the incidence of abnormal flap appearance and enhancement rates between the brimonidine and nonbrimonidine groups. RESULTS: In the brimonidine group, six of 39 eyes (15.4%) had an abnormal flap appearance after LASIK, although no flap folds or dislocations were noted in the nonbrimonidine groups. The difference in incidence of abnormal flap appearance between the brimonidine group and the prior and post nonbrimonidine groups was statistically significant (p = 0.0008 and p = 0.0003, respectively). When the prior and post nonbrimonidine groups were combined and compared to the brimonidine group, the difference in flap adherence was highly statistically significant (p = 0.00001). The enhancement rate was significantly higher in the brimonidine group at 36% compared with 14% in the prior nonbrimonidine group (p = 0.01) and 9% in the post nonbrimonidine group (p = 0.0004). The mean three-month postoperative spherical equivalent was significantly greater at -0.88 D in the brimonidine group compared with -0.24 D (p = 0.0008) and -0.15 D (p = 0.0001) in the prior and post nonbrimonidine groups, respectively. CONCLUSIONS: In this study, when perioperative topical brimonidine was used in LASIK patients, an increase in the incidence of abnormal flap adherence and an increase in enhancement rates was observed.
Dr K.A. Walter, Department of Ophthalmology, Wake Forest University School of Medicine, Wake Forest University Eye Center, Medical Center Boulevard, Winston-Salem, NC 27157-1033, USA
Classification:
11.3.3 Apraclonidine, brimonidine (Part of: 11 Medical treatment > 11.3 Adrenergic drugs)
