Effect of Topical Hypotensive Medications for Preventing Intraocular Pressure Increase after Cataract Surgery in Eyes with Glaucoma

ABSTRACT PURPOSE To compare the effects of a topical intraocular pressure (IOP)-lowering medication for preventing an IOP increase after cataract surgery in eyes with glaucoma. DESIGN Randomized clinical study. METHODS One hundred sixty-five eyes of 165 patients with primary open-angle glaucoma or pseudoexfoliation glaucoma scheduled for phacoemulsification were randomly assigned to one of three groups to receive each medication immediately postoperatively: 1) prostaglandin F2α analogue (travoprost), 2) β-blocker (timolol maleate), or 3) carbonic anhydrase inhibitor (brinzolamide). IOP was measured using a rebound tonometer at 1 h preoperatively; at the end of surgery; and at 2, 4, 6, 8, and 24 h postoperatively. The incidence of eyes exhibiting a marked IOP increase to greater than 25 mmHg was compared between goups. RESULTS At 1 h preoperatively and at the end of surgery, mean IOP did not differ significantly among groups. Mean IOP significantly increased between 4 and 8 h postoperatively, and then decreased at 24 h postoperatively in all groups (P CONCLUSION Brinzolamide more effectively reduces the short-term IOP increase after cataract surgery compared with travoprost or timolol in eyes with glaucoma, suggesting that brinzolamide is preferable for preventing an IOP spike.