Anterior Segment Nd:YAG Laser Procedures: to Study Intraocular Pressure Spikes and Their Prevention

Abstract

Purpose: To find out quantum of increase in intraocular pressure (IOP) following anterior segment Nd:YAG laser procedures and extent to which this increase is preventable by different groups of anti- glaucoma drugs. Methods: Study design: Cross sectional, randomized, double blind analytical study. One hundred and seventy four eyes of 174 patients who underwent anterior segment Nd:YAG laser procedures {peripheral iridotomy (LPI)/ capsulotomy (YLC)}, using energy limited to 50 mJ, were randomized into five groups. Patients in group 1, 2, 3, 4 and 5 received topical Brimonidine tartarate 0.2%, oral Acetazolamide 250mg, topical Dorzolamide hydrochloride 2%, lubricating eye drops plus oral calcium tablets and topical Timolol maleate 0.5% respectively.Patients getting active topical drug were additionally given oral calcium and those getting oral active drug were given topical lubricating drops in a double blind manner. Intraocular pressure was measured at 1, 3, 5 and 24 hours post laser. Results: Rise of IOP from baseline to 1, 3, 5 or 24 hours was not found to be significant in any of the groups receiving ocular hypotensive drug (p>0.05). In the placebo group, the rise of IOP was significant only in one patient at 1, 3 and 5 hours post laser which came down to insignificant levels at 24 hours. Conclusion: Limiting the use of energy (< 50 mJ/ sitting) during Nd:YAG laser procedures may prevent post laser IOP spikes and obviate the use of ocular hypotensive drugs. In high risk cases, amongst the anti glaucoma drugs, a agonists can be prescribed.