By Walter Alexander
NEW YORK -- June 29, 2020 -- Preoperative application of brimonidine 0.15% significantly reduces the severity of subconjunctival haemorrhage following femtosecond laser-assisted cataract surgery, according to a study presented at the 2020 Virtual Meeting and Exposition of the Canadian Ophthalmological Society (COS).
The study is the first to evaluate the vasoconstrictive effect of brimonidine on femtosecond laser-assisted cataract surgery, said Eric S. Tam, MD, University of Toronto, Toronto, Ontario.
“Furthermore, no objective, standardised method to quantify subconjunctival haemorrhage following ophthalmic procedures has been established,” he said.
For the study, Dr. Tam and colleagues analysed 62 patients who underwent femtosecond laser-assisted cataract surgery between June 2019 and August 2019. All operated eyes received the usual preoperative drops, but 25 eyes also received an additional drop of brimonidine 0.15%. Subconjunctival hemorrhage was assessed via the Bulbar Redness score.
Results showed that mean Bulbar Redness scores were significantly reduced among the patients receiving brimonidine -- from 1.62 ± 0.52 to 1.42 ± 0.34. Bulbar Redness score increased from 1.40 ± 0.34 to 1.46 ± 0.43 among the 37 controls.
Differences in Bulbar Redness Scores preoperatively versus postoperatively were not different for each group. What was significant, was the difference in mean change in Bulbar Redness score in the brimonidine group (-0.21 ± 0.56 vs +0.06 ± 0.43; P = .03).
Dr. Tam displayed images of eyes typical of what was observed in the study and noted that among patients receiving brimonidine, “there is a general blanching of the conjunctival vessels compared with pre-op with small patches of conjunctival haemorrhage present. Among control patients, there is significantly more subconjunctival haemorrhage in the shape of a ring consistent with the suction cup applied during femtosecond laser-assisted cataract surgery.”
He noted that the preoperative use of phenylephrine 10% for pupil dilation in both groups may have masked the effects of brimonidine.
[Presentation title: The Effect of Brimonidine 0.15% on the Development of Subconjunctival Hemorrhage Following Femtosecond Laser Assisted Cataract Surgery]
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