dorzolamide and Postoperative-Complications

OBJECTIVE To assess the effects of topically applied 2% dorzolamide hydrochloride-0.5% timolol maleate ophthalmic solution (DHTM) on incidence and severity of postoperative ocular hypertension (POH; ie, intraocular pressure [IOP] > 25 mm Hg) in dogs undergoing cataract extraction by phacoemulsification. DESIGN Randomized, masked, controlled study. ANIMALS 103 dogs (180 eyes). PROCEDURES Pertinent history, signalment, and ophthalmic examination findings were recorded. Dogs received 1 drop of DHTM or sham treatment solution (sterile, buffered, isotonic eye drops) in both eyes 14 hours and 2 hours before anesthetic induction and at the time of corneal incision closure (ie, end of surgery); IOPs were assessed by rebound tonometry 2, 4, 6, and 8 hours after surgery and between 7:30 and 8:00 am on the following day. Dogs with IOPs of 26 to 45 mm Hg received 1 drop of 0.005% latanoprost solution topically; the surgeon's treatment of choice was used for dogs with IOPs > 45 mm Hg. Incidence of POH and postoperative IOPs were compared between treatment groups. RESULTS DHTM treatment resulted in significantly lower incidence of POH than did sham treatment at the level of the dog (18/53 [34%] vs 31/50 [62%]) and the eye (24/94 [26%] vs 42/86 [48%]). Mean IOP did not differ between groups at the time of POH detection. The DHTM-treated eyes that developed POH were significantly more likely to have a 1-hour follow-up IOP < 25 mm Hg after latanoprost administration than were sham-treated eyes (19/25 [76%] vs 18/35 [51%]; OR, 3.87). CONCLUSIONS AND CLINICAL RELEVANCE Multidose perioperative administration of DHTM in dogs undergoing phacoemulsification reduced the incidence of POH and improved responsiveness of POH to latanoprost treatment.

Topics: Animals; Antihypertensive Agents; Cataract Extraction; Dog Diseases; Dogs; Drug Combinations; Ocular Hypertension; Perioperative Care; Postoperative Complications; Sulfonamides; Thiophenes; Timolol

To compare the effects of dorzolamide-timolol combination and brimonidine on intraocular pressure (IOP) after phacoemulsification surgery.. This prospective, randomized study included 69 eyes of 43 patients undergoing phacoemulsification and foldable intraocular lens implantation. Twenty-one patients were women and 22 were men. The mean patient age was 69.7+/-12.4 years. Patients were randomly assigned to one of three treatment groups preoperatively. Group A (n=23) received one drop of dorzolamide-timolol fixed combination and group B (n=23) received one drop of brimonidine tartrate 0.2% immediately after surgery. In group C (n=23), patients received no treatment and served as a control group. IOP was measured by Goldmann applanation tonometry 6 hours and 24 hours after surgery.. Six hours after surgery, the mean IOP was significantly lower in group A (16.3+/-2.9 mm Hg) than in groups B (20.6+/-2.9 mm Hg) and C (24.6+/-5.4 mm Hg). However, 24 hours after surgery, the mean IOP was higher in group C (19.8+/-4.7 mm Hg) than in the other two groups (14.1+/-2.8 mm Hg in group A and 17.5+/-2.7 mm Hg in group B).. Prophylactic treatment with dorzolamide-timolol fixed combination was more effective than brimonidine in reducing IOP 6 hours and 24 hours after phacoemulsification surgery.

Topics: Aged; Antihypertensive Agents; Brimonidine Tartrate; Drug Combinations; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Intraocular Pressure; Lens Implantation, Intraocular; Male; Ocular Hypertension; Phacoemulsification; Postoperative Care; Postoperative Complications; Prospective Studies; Quinoxalines; Sulfonamides; Thiophenes; Timolol; Treatment Outcome

To assess the safety, in terms of the intraocular pressure (IOP), of cataract surgery with primary posterior continuous curvilinear capsulorhexis (PPCCC) and a postoperative dose of a fixed dorzolamide-timolol combination and evaluate the effect of intraocular lens (IOL) haptic angulation.. Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.. In this prospective randomized double-masked bilateral study, 88 eyes of 44 consecutive patients with age-related cataract were included in an intraindividual comparison study. All patients had standardized cataract surgery with PPCCC and IOL implantation in the capsular bag followed by a postoperative dose of a fixed dorzolamide-timolol combination. Patients were randomly assigned to receive an ACR6D SE IOL (Laboratoires Cornéal) in 1 eye and a Centerflex (C-flex) 570C IOL (Rayner Surgical GmbH) in the contralateral eye. The IOP was measured at baseline and postoperatively at 6 and 24 hours as well as 1 week.. Intraindividual comparison showed statistically significantly higher IOP measurements in the C-flex 570C nonangulated IOL group than in the ACR6D SE angulated IOL group at 24 hours (P = .003) and 1 week (P = .043). The highest IOP spikes (34 mm Hg) were at 6 hours in 2 eyes with a C-flex 570C IOL. The ACR6D SE group had statistically significant changes in IOP between preoperative and all postoperative time points. In the C-flex 570C group, the only statistically significant change in IOP was between preoperatively and 6 hours postoperatively.. Cataract surgery with PPCCC was safe in terms of the postoperative IOP course. Haptic angulation slightly decreased the overall IOP rise and the incidence of IOP rises above 30 mm Hg.

Topics: Aged; Aged, 80 and over; Antihypertensive Agents; Capsulorhexis; Cataract; Combined Modality Therapy; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Intraocular Pressure; Lens Implantation, Intraocular; Lenses, Intraocular; Male; Middle Aged; Ocular Hypertension; Postoperative Complications; Prospective Studies; Prosthesis Design; Sulfonamides; Thiophenes; Timolol

To determine whether a single topical aqueous suppressant applied immediately after pars plana vitrectomy with long-acting gas tamponade prevents intraocular pressure (IOP) elevation.. Fifty patients who met the inclusion criteria and underwent pars plana vitrectomy with long-acting gas tamponade were randomized to receive a combination of timolol maleate and dorzolamide hydrochloride, long-acting timolol alone, dorzolamide alone, or placebo at the conclusion of surgery. The IOP was checked by a portable, handheld tonometer (Tono-Pen) at the conclusion of surgery and at 5 hours, 1 day, and 1 week after surgery.. There were no significant differences in IOP among the groups at the conclusion of surgery. The IOP at 5 hours after surgery (27.0 vs 17.4 mm Hg; P<.001) and 1 day after surgery (26.1 vs 19.9 mm Hg; P =.01) showed a statistically significant difference between the placebo and timolol-dorzolamide groups. The timolol-dorzolamide group showed greater IOP control than either the timolol alone or the dorzolamide alone groups at 5 hours (P =.04 for both).. The use of a single topical aqueous suppressant (timolol-dorzolamide) given after pars plana vitrectomy with long-acting gas tamponade effectively prevents significant postoperative IOP elevation at 5 hours and 1 day after surgery.

Topics: Administration, Topical; Adult; Aged; Aged, 80 and over; Antihypertensive Agents; Drug Therapy, Combination; Female; Fluorocarbons; Humans; Intraocular Pressure; Male; Middle Aged; Postoperative Complications; Postoperative Period; Prospective Studies; Retinal Detachment; Retinal Perforations; Sulfonamides; Sulfur Hexafluoride; Thiophenes; Timolol; Vitrectomy

To compare the ocular hypotensive effect of different antiglaucomatous eye drops.. This double-blind, randomized study included 119 eyes of 119 patients without other ocular pathology undergoing standardized (one surgeon, Healon) small incision cataract surgery with foldable intraocular lens implantation. The patients were assigned to one of five groups: group 1: 0.25% timolol in Gelrite (extended efficacy, n = 23); group 2: 2% dorzolamide (n = 24); group 3: combination of 0.5% timolol plus 2% dorzolamide (n = 22); group 4: brimonidine (n = 26); group 5: gentamicin (control, n = 24). Intraocular pressure (IOP) was measured preoperatively and at 3 +/- 1, 6 +/- 1, 9 +/- 1, 24 +/- 3, and 48 +/- 3 h postoperatively. Statistical interference was determined by nonparametric group comparisons using Wilcoxon's tests. Absolute values (static comparison) and intraindividual differences from preoperative measurements (dynamic comparisons) were evaluated. All p values should be regarded as descriptive values since they were not formally adjusted for multiplicity. A p value lower than 0.05 therefore indicates local statistical significance.. There were no differences between the groups with regard to age, phacoemulsification time, axial length, and preoperative IOP. A statistically significant IOP decrease was measured in group 1 at 24 (p = 0.028) and 48 h (p = 0.007) and in group 3 at 3 (p = 0.001), 6 (p = 0.001), 24 (p = 0.001), and 48 h (p = 0.001) after surgery. A statistically significant IOP increase occurred in group 4 at 3 (p = 0.001), 6 (p = 0.001), and 9 h (p = 0.001) and in group 5 at 3 (p = 0.001), 6 (p = 0.001), 9 (p = 0.001), and 24 h (p = 0.002) postoperatively. Groups 1, 2, and 3 demonstrated lower IOPs at different time points in comparison to groups 4 and 5. Furthermore, group 3 had lower IOPs at 3 h (compared to group 1) and at 6 h (compared to group 2) postoperatively. No statistical differences in IOP were found after 48 h.. The results favor a combination of 0.5% timolol plus 2% dorzolamide to control postoperative IOP elevation.

Topics: Adrenergic alpha-Agonists; Adrenergic beta-Antagonists; Adult; Aged; Antihypertensive Agents; Brimonidine Tartrate; Carbonic Anhydrase Inhibitors; Data Interpretation, Statistical; Double-Blind Method; Drug Therapy, Combination; Humans; Intraocular Pressure; Lens Implantation, Intraocular; Middle Aged; Ophthalmic Solutions; Phacoemulsification; Polysaccharides, Bacterial; Postoperative Care; Postoperative Complications; Quinoxalines; Sulfonamides; Thiophenes; Time Factors; Timolol

To evaluate the efficacy of 2% dorzolamide hydrochloride opthalmic solution in preventing spikes in intraocular pressure (IOP) after anterior segment laser surgery.. This 24-hour, placebo-controlled, randomized, double-masked, multicenter evaluation was conducted to determine the efficacy of dorzolamide hydrochloride 2% in controlling IOP after neodimium:yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy, argon laser trabeculoplasty, or laser iridotomy. The 122 patients enrolled were assigned in randomized fashion to receive dorzolamide or placebo 1 hour before and immediately after the procedure; IOP was measured 1, 2, 3, 4, and 24 hours after the procedure.. Of 61 patients receiving dorzolamide, only one (1.7%) had a spike in IOP of 10 mmHg or more, compared with 9 (14.8%) of the 61 patients receiving placebo. Mean IOP among patients receiving dorzolamide was significantly reduced both from baseline and compared with that among patients receiving placebo from 1 to 4 hours after administration. Only 5 (8%) of the 61 patients receiving dorzolamide experienced at least one adverse event, compared with 15 (25%) of the 61 patients receiving placebo.. Dorzolamide was effective in preventing spikes in IOP after anterior segment laser surgery. Dorzolamide was generally well tolerated after short-term use.

Topics: Anterior Eye Segment; Carbonic Anhydrase Inhibitors; Double-Blind Method; Humans; Intraocular Pressure; Laser Therapy; Ocular Hypertension; Ophthalmic Solutions; Postoperative Complications; Sulfonamides; Thiophenes

The aim of the present study was to examine the influence of the topical carbonic anhydrase-II-inhibitor dorzolamide hydrochloride (Trusopt) in regarding to behaviour of intraocular eyepressure after Nd:YAG-laser-capsulotomy.. The study was carried out as a double-blind-test. In a period of nine months, 120 patients underwent Nd:YAG-laser-capsulotomy. One group was given dorzolamide hydrochloride (Trusopt), the other group (placebo) remained without medication. The intraocular pressure was measured before capsulotomy and four hours post-op. For statistical evaluation the t-test of not-associated spot-checks was performed.. The prophylactic use of the topical carbonic anhydrase-II-inhibitor dorzolamide hydrochloride (Trusopt) after nd:YAG-laser-capsulotomy shows a highly significant lowering of intraocular pressure, i.e. 1.09 mm Hg in the average.. It was demonstrated that a single dose of dorzolamide hydrochloride (Trusopt) after Nd:YAG-laser-capsulotomy could lower intraocular pressure significantly. Prophylactical usage of dorzolamide hydrochloride (Trusopt) is a useful method to prevent the increase of intraocular pressure and thus to protect the eye against hazardous damage.

Topics: Aged; Aged, 80 and over; Carbonic Anhydrase Inhibitors; Cataract Extraction; Double-Blind Method; Female; Humans; Intraocular Pressure; Laser Therapy; Male; Ocular Hypertension; Ophthalmic Solutions; Postoperative Complications; Premedication; Sulfonamides; Thiophenes; Treatment Outcome

To compare the efficacy and safety of topical 2.0% dorzolamide hydrochloride with oral acetazolamide in preventing intraocular pressure (IOP) rise following neodymium:YAG (Nd:YAG) laser posterior capsulotomy.. A prospective, randomized, double-masked, placebo-controlled study.. Two hundred ten patients undergoing Nd:YAG laser posterior capsulotomy.. Pretreatment with dorzolamide, acetazolamide, or placebo. Dorzolamide administration as a single drop (1 drop approximately 20 microL) 1 hour before capsulotomy. Acetazolamide administration as a single dose of 125 mg orally 1 hour before capsulotomy.. At first and third hour postoperatively, IOPs and IOP changes from baseline were significantly (P<.001) higher in the placebo group than in the dorzolamide or acetazolamide group. At the same time, IOPs and IOP changes from baseline were similar (P>.50) in the dorzolamide and acetazolamide groups. No patient treated with dorzolamide or acetazolamide experienced an IOP higher than 30 mm Hg after capsulotomy, but 15.7% of patients receiving placebo had an IOP above this level (P<.001). Of patients receiving placebo, 5.7% experienced IOP higher than 35 mm Hg. No serious side effects were recorded in any of the studied patients.. Topical 2.0% dorzolamide and oral acetazolamide, given prophylactically as a single administration 1 hour before Nd:YAG laser posterior capsulotomy, have comparable high efficacy and safety in preventing IOP elevation following this procedure.

Topics: Acetazolamide; Administration, Oral; Administration, Topical; Aged; Aged, 80 and over; Carbonic Anhydrase Inhibitors; Cataract Extraction; Double-Blind Method; Female; Follow-Up Studies; Humans; Intraocular Pressure; Laser Therapy; Lens Capsule, Crystalline; Male; Middle Aged; Ocular Hypertension; Ophthalmic Solutions; Postoperative Complications; Prospective Studies; Safety; Sulfonamides; Thiophenes; Treatment Outcome

To determine whether topical hypotensive medications prevent postoperative ocular hypertension (POH) after phacoemulsification.. 52 client-owned dogs (88 eyes).. Diabetic and nondiabetic dogs having undergone phacoemulsification were included in this retrospective study. The control group received no ocular hypotensive medications. The treatment groups received latanoprost, dorzolamide, or dorzolamide/timolol, beginning immediately after surgery, for 2-week duration. IOPs were obtained at initial examination followed by 4 h, 24 h, 7 days, and 14 days postoperatively. POH was defined as an IOP above 20 mmHg (POH20) or 25 mmHg (POH25).. POH20 occurred in 33 of 87 eyes (37.93%), including 11 of 21 eyes (52.38%) in the control group, three of 23 eyes (13.04%) in the latanoprost group, eight of 15 eyes (53.33%) in the dorzolamide group, and 11 of 28 eyes (39.29%) in the dorzolamide/timolol group. Active treatment groups were compared to the control group, and the overall group effect was not significant (P = 0.11). POH25 occurred in 22 of 86 eyes (25.58%), including seven of 21 eyes (33.33%) in the control group, two of 23 eyes (8.70%) in the latanoprost group, five of 15 eyes (33.33%) in the dorzolamide group, and eight of 27 eyes (29.63%) in the dorzolamide/timolol group. Active treatment groups were compared to the control group, and the overall group effect was not significant (P = 0.31). Intraoperative use of intracameral tissue plasminogen activator significantly decreased the chances of POH25 (P = 0.0063).. The latanoprost group had a substantially lower percentage of POH 20 and POH25 compared to the control and other active treatment groups, although statistical significance was not achieved. Intraoperative intracameral tissue plasminogen activator decreased the incidence of POH25.

Topics: Administration, Topical; Animals; Dog Diseases; Dogs; Female; Incidence; Intraocular Pressure; Latanoprost; Male; Ocular Hypertension; Ophthalmic Solutions; Phacoemulsification; Postoperative Complications; Pre-Exposure Prophylaxis; Prostaglandins F, Synthetic; Retrospective Studies; Sulfonamides; Thiophenes; Timolol

Topics: Acetazolamide; Acute Disease; Anesthesia, General; Atropine; Combined Modality Therapy; Corneal Edema; Dexamethasone; Drug Therapy, Combination; Female; Glaucoma, Angle-Closure; Humans; Laser Therapy; Mannitol; Middle Aged; Mydriasis; Pilocarpine; Postoperative Complications; Sulfonamides; Thiophenes; Timolol; Vomiting

A case of a patient with Weill-Marchesani syndrome who developed a secondary glaucoma due to synechiae in both eyes is described. As intraocular pressure (IOP) could not be controlled with medical treatment in the left eye (LE), the patient underwent glaucoma filtering surgery. IOP was controlled and no complications occurred. However, 15 months later, athalamia stage 1 was diagnosed in the LE, without any alterations in the posterior pole. To solve this complication, a vitrectomy with lens extraction and intraocular lens implantation in the LE was performed. Currently, IOP is 12 mmHg and the anterior chamber remains deep.. The association of vitrectomy and lens surgery in those cases where there is a predisposition to forward movement of the lens, might reduce intra and postoperative complications.

Topics: Abnormalities, Multiple; Adult; Cataract Extraction; Combined Modality Therapy; Drug Resistance; Dwarfism; Female; Fingers; Glaucoma, Angle-Closure; Hand Deformities, Congenital; Humans; Intraocular Pressure; Iridectomy; Lens Implantation, Intraocular; Lens, Crystalline; Mitomycins; Phacoemulsification; Postoperative Complications; Sulfonamides; Syndrome; Thiophenes; Trabeculectomy; Vitrectomy

Topics: Acetazolamide; Administration, Oral; Administration, Topical; Carbonic Anhydrase Inhibitors; Humans; Intraocular Pressure; Phacoemulsification; Postoperative Complications; Sulfonamides; Thiophenes