Effects of 0.5% and 0.25% apraclonidine on postoperative intraocular hypertension after cataract extraction

We conducted a double-masked, prospective study to evaluate the effect of 0.5% and 0.25% apraclonidine on postoperative intraocular pressure (IOP) in patients undergoing extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation.

Fifty-four patients scheduled for ECCE were randomly divided into three groups of 18. The first group received one drop of 0.50% apraclonidine topically one hour before surgery and immediately after the end of the procedure. The second group received the same regimen but with 0.25% apraclonidine. The third group received artificial tears as the control group. IOP was measured 12 h preoperatively and 6 and 24 h postoperatively. All the measurements were made using the same Goldmann applanation tonometer by the same surgeon who did not know to which group the patient belonged.

Preoperative mean IOP was 13.66 +/- 2.76 mmHg in the first group, 14.27 +/- 2.24 mmHg in the second and 14.5 +/- 1.34 mmHg in the control group. The differences were not significant (p = 0.398). Mean IOP at the early postoperative visit (6 h) was significantly lower in the first group (17.44 +/- 4.95 mmHg) than the second (21.78 +/- 7.19 mmHg) and the control group (24.55 +/- 5.65 mmHg) (p < 0.001). Mean postoperative IOP at 24 h was again significantly lower in the first group (14.33 +/- 3.75 mmHg) than the second (17.11 +/- 4.16 mmHg) and the control group (19.61 +/- 3.20 mmHg) (p, 0.001).

Our findings indicate that topical 0.5% apraclonidine controlled early postoperative intraocular hypertension after cataract extraction without any side effects, while the 0.25% drops were not effective.