Comparative efficacy of acetazolamide and apraclonidine in the control of intraocular pressure following phacoemulsification.

PURPOSE: The purpose of our study was to compare the effects of systemically administered acetazolamide and topical apraclonidine 0.5% in the control of intraocular pressure (IOP) following phacoemulsification of senile cataracts.

SETTING: The study was conducted on patients affected by cataract and followed at the Department of Ophthalmology.

METHODS: Seventy-eight eyes in 78 patients were selected. Twenty-six eyes were randomly assigned to postoperative treatment with topical apraclonidine 0.5%, 26 received oral acetazolamide and the remaining 26 received no hypotensive treatment (control group). Statistical analyses were performed mainly by means of analyis of variance.

RESULTS: IOPs measured 24 h after surgery were significantly (p = 0.01) lower in the apraclonidine group compared to the control group.

CONCLUSIONS: Our double-blind prospective study conducted on patients randomly assigned to treatment with apraclonidine or acetazolamide shows that the former drug is undoubtedly effective in the prevention of IOP increases following phacoemulsification. IOPs recorded in patients treated with this drug were lower than those observed in the acetazolamide and the control groups. Considering the lower risk of toxicity associated with topical administration, apraclonidine 0.5% seems to be preferable to oral acetazolamide in this postoperative setting.