The effect of prophylactic acetazolamide in patients undergoing extensive retinal detachment repair

Encirclement of the eye as part of a retinal detachment repair is known to raise the post-operative intraocular pressure. We studied the effect of anticipating this pressure rise by giving perioperative acetazolamide to patients having vitrectomy and encirclement procedures. Two groups (9 with acetazolamide and 14 without) were matched for biographic variables, type of detachment and operation variables. The group given acetazolamide had lower day 1 post-operative intraocular pressures (mean 22.11 mmHg vs 36.36 mmHg, p = 0.002) and were able to go home sooner (mean 1.56 days vs 3.29 days, p = 0.001). No adverse effects of short-term acetazolamide use were noted in this study. We conclude that patients having extensive scleral buckling procedures should all receive prophylactic acetazolamide unless it is specifically contraindicated.