Effect of prophylactic intraocular pressure-lowering medication on pain during cataract surgery.

Abstract

PURPOSE:

This study evaluated the effects of acetazolamide, latanoprost, travoprost, bimatoprost, brimonidine, brinzolamide, and timolol on pain during phacoemulsification cataract surgery.

METHODS:

This prospective randomized comparative study included 323 eyes of 323 patients with no history of intraocular surgery or chronic eye disease who underwent uncomplicated phacoemulsification cataract surgery and foldable intraocular lens implantation under topical anesthesia. Patients were divided into 8 groups according to the preoperative prophylactic intraocular pressure (IOP)-lowering medication. The intraoperative pain was assessed postoperatively using a visual analog pain scale. The Kruskal-Wallis test investigated the differences in the visual analog pain-scale scores of the groups, and the Mann-Whitney U test investigated the pairwise comparison of the groups.

RESULTS:

The median visual analog pain-scale score of the group that did not receive any IOP-lowering medication was 2.0±1.89. The brimonidine group exhibited the lowest visual analog pain-scale scores, and the prostanoids, especially the bimatoprost group, demonstrated the highest visual analog pain-scale scores (median±standard deviation were 0.0±1.50 and 2.0±1.91, respectively). The median visual analog pain-scale scores of the acetazolamide, latanoprost, travoprost, brinzolamide, and timolol groups were 0.0±1.62, 2.0±1.67, 2.0±1.73, 0.0±1.66, and 1.0±1.54, respectively. A pairwise comparison using the Mann-Whitney U test with Bonferroni correction revealed significant differences between the groups of acetozolamide and travoprost (p=0.001), acetozolamide and bimatoprost (p<0.001), travoprost and brimonidine (p<0.001), bimatoprost and brimonidine (p<0.001), and bimatoprost and timolol (p=0.001).

CONCLUSIONS:

Prophylactic application of the IOP-lowering medication may alter the pain sensation during phacoemulsification cataract surgery.

• Authors: Fatih Ulaş, Mehmet Balbaba, Serdal Çelebi
• Journal: Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics (J Ocul Pharmacol Ther) Vol. 29 Issue 7 Pg. 658-62 (Sep 2013) ISSN: 1557-7732 [Electronic] United States
• PMID: 23461283 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Amides
• Antihypertensive Agents
• Drug Combinations
• Prostaglandins F, Synthetic
• Quinoxalines
• Sulfonamides
• Thiophenes
• dorzolamide-timolol combination
• Cloprostenol
• Brimonidine Tartrate
• Latanoprost
• Timolol
• Acetazolamide
• Bimatoprost
• Travoprost

Topics

• Acetazolamide (therapeutic use)
• Adult
• Aged
• Aged, 80 and over
• Amides (therapeutic use)
• Antihypertensive Agents (therapeutic use)
• Bimatoprost
• Brimonidine Tartrate
• Cataract (drug therapy)
• Cloprostenol (analogs & derivatives, therapeutic use)
• Combined Modality Therapy
• Drug Combinations
• Drug Therapy, Combination
• Female
• Glaucoma, Open-Angle (drug therapy, pathology)
• Humans
• Intraocular Pressure (drug effects)
• Latanoprost
• Male
• Middle Aged
• Pain (drug therapy)
• Phacoemulsification
• Postoperative Period
• Prospective Studies
• Prostaglandins F, Synthetic (therapeutic use)
• Quinoxalines (therapeutic use)
• Sulfonamides (therapeutic use)
• Thiophenes (therapeutic use)
• Timolol (therapeutic use)
• Travoprost