Biphasic intraocular pressure response to Q-switched Nd:YAG laser irradiation of the iris and the apparent mediatory role of prostaglandins

Abstract

In rabbits, laser irradiation of the iris causes an immediate rise in intraocular pressure (IOP), with a concomitant increase of prostaglandins (PGs) in the aqueous humor. We studied IOP responses to Q-switched Nd:YAG laser application to the iris in unanesthetized rabbits, and found that a prolonged IOP reduction lasting for 6–24 hr invariably followed the transient IOP rise of 0·5-2 hr duration. The magnitude of both the IOP rise and reduction was dependent on the level of laser energy. A masked, randomized study revealed that the intraperitoneal administration of indomethacin (50 mg kg −1) prior to laser application significantly reduced the ocular hypertensive and hypotensive responses to laser irradiation (energy: 24 mJ). The maximum IOP rise from baseline was 5·4±3·0 mmHg ( n = 10) with the intraperitoneal vehicle and 1·5±4.2 mmHg ( n = 10) with intraperitoneal indomethacin administration. Thus, the difference was statistically significant ( P < 0·025, Student's t-test). The maximum IOP reduction from baseline was −8·5±2·6 mmHg ( n = 10) with the intraperitoneal vehicle and −4·0±2·4 mmHg ( n = 10) with intraperitoneal indomethacin ( P < 0·001, Student's t-test). The concentration of PGE 2 in the aqueous humor, as determined by radioimmunoassay on samples obtained at 2 and 4 hr after laser application, was found to be significantly increased in rabbits that received the vehicle solution but not in animals that were pretreated with intraperitoneal injection of indomethacin. This suggests that this PG or other cyclooxygenase products are involved with mediation of the initial IOP increase and the prolonged decrease in IOP that follows laser irradiation of the iris.