Role of prophylactic use of timolol maleate (0.5%) in preventing rise of intraocular pressure (iop) post Neodymium: Yttrium Aluminum Garnet (Nd: Yag) capsulotomy

Abstract

Purpose: To evaluate the role of prophylactic use of Timolol maleate (0.5%) eye drop in preventing rise of intraocular pressure (IOP) post Nd: YAG capsulotomy.

Materials and Methods: A randomized, single-blinded, parallel group study conducted in 220 eyes, over a period of 18 months. Precapsulotomy baseline IOP, Slitlamp examination and grading of PCO was done. After instilling the test medication Nd: YAG laser capsulotomy performed. Post capsulotomy patients were assessed immediately, after 1 hour and 3 hours for IOP.

Result: Precapsulotomy, mean IOP in Group I (use of placebo) was 15.30 ± 2.83 mm Hg as compared to 16.15 ± 2.48 mmHg in Group II (use of Timolol eyedrop), Group II mean IOP was significantly higher (P = 0.019). However, immediately after the procedure mean IOP in Group I was 14.55 ± 2.87 mmHg as compared to 13.16 ± 3.72 mmHg in Group II thus showing mean IOP in Group II to be significantly lower (P = 0.002). One hour and 3 hours after the procedure too, mean IOP in Group II was significantly lower as compared to that in Group I (P < 0.001). With increasing grade of PCO reduction in post-procedure IOP was lower and reduction in IOP was maximum in patients requiring <30 milliJoules of total energy.

Conclusion: A judicious control over energy use and post laser IOP monitoring can influence the trend of IOP rise in a positive manner. Whenever anticipated that >60 mJ of laser energy is required as in higher grades and younger age, prophylactically Timolol maleate 0.5% eye drop should be instilled before Nd: YAG capsulotomy while all other patients in which Timolol is not used, should be kept under observation after laser capsulotomy.

Keywords: Capsulotomy, grade of posterior capsular opacification, intra ocular pressure, Nd: YAG laser, Timolol maleate