PURPOSE: To evaluate the effect of prophylactic brimonidine on bleeding complicationsafter cataract surgery. METHODS: The authors performed a prospective, double-masked, two-surgeon study of 137 patients (137 eyes) who underwentphacoemulsification and intraocular lens implantation with or without prophylactic brimonidinebefore cataract surgery. The authors also compared the effect of brimonidine among patients with systemic diseases such as diabetes mellitus (types I and II), hypertension, and anticoagulant or antiplatelet treatment. RESULTS:Subconjunctival hemorrhage was observed in 73.70% of the patients not treated with brimonidine before surgery and in only 23.75% of the patients who were given prophylactic brimonidine (p<0.001, chi2). The grade of hemorrhage was also statistically significant (p<0.001, Mann-Whitney). No statistically significant difference with regard to the presence of hemorrhage in diabetic patients or in the anticoagulant or antiplatelet treatment group was observed. However, a statistically significant difference (p<0.027, chi2) was found between hypertensive patients treated and not treated with prophylactic brimonidinebefore cataract surgery. CONCLUSIONS: This study suggests that brimonidine administered before cataract surgery may significantly reduce subconjunctival hemorrhage in the general population. It has been shown to be beneficial in hypertensive patients. A strong statistical trend, but not significance has been found in diabetic patients or in patients treated with antiplatelet or anticoagulant drugs, but further studies are needed to reach conclusive results.
RCT Entities:
PURPOSE: To evaluate the effect of prophylactic brimonidine on bleeding complications after cataract surgery. METHODS: The authors performed a prospective, double-masked, two-surgeon study of 137 patients (137 eyes) who underwent phacoemulsification and intraocular lens implantation with or without prophylactic brimonidine before cataract surgery. The authors also compared the effect of brimonidine among patients with systemic diseases such as diabetes mellitus (types I and II), hypertension, and anticoagulant or antiplatelet treatment. RESULTS:Subconjunctival hemorrhage was observed in 73.70% of the patients not treated with brimonidine before surgery and in only 23.75% of the patients who were given prophylactic brimonidine (p<0.001, chi2). The grade of hemorrhage was also statistically significant (p<0.001, Mann-Whitney). No statistically significant difference with regard to the presence of hemorrhage in diabeticpatients or in the anticoagulant or antiplatelet treatment group was observed. However, a statistically significant difference (p<0.027, chi2) was found between hypertensivepatients treated and not treated with prophylactic brimonidine before cataract surgery. CONCLUSIONS: This study suggests that brimonidine administered before cataract surgery may significantly reduce subconjunctival hemorrhage in the general population. It has been shown to be beneficial in hypertensivepatients. A strong statistical trend, but not significance has been found in diabeticpatients or in patients treated with antiplatelet or anticoagulant drugs, but further studies are needed to reach conclusive results.
Authors: Mari Carmen Desco; Julio Cesar Molina Martín; Jorge Mataix-Boronat; Isabel Pascual-Camps; Elena Palacios-Pozo; Marisa Barón-García; David P Piñero; Amparo Navea-Tejerina Journal: Ther Adv Ophthalmol Date: 2021-10-05