Medical control of intraocular pressure after cataract surgery

J Cataract Refract Surg. 1998 Nov;24(11):1493-7. doi: 10.1016/s0886-3350(98)80172-7.


Purpose: To compare the effectiveness of 2 medications commonly used to prevent intraocular pressure (IOP) elevation in the early period after cataract surgery.

Setting: Palo Alto Veterans Affairs Health Care System, Palo Alto, California, USA.

Methods: This prospective study comprised 202 eyes of patients scheduled for cataract extraction who agreed to participate. Patients were randomized to receive oral acetazolamide, 500 mg 1 hour preoperatively; oral acetazolamide, 500 mg immediately postoperatively; apraclonidine hydrochloride 1%, 2 drops 1 hour preoperatively; or artificial tears (control group). Intraocular pressure was measured preoperatively and 4 to 6 and 24 hours postoperatively.

Results: Preoperative IOP was not significantly different among the 4 groups. At 4 to 6 hours postoperatively, only preoperative acetazolamide was significantly more effective than the control medication (P = .038); at 24 hours there were no significant differences among the 4 groups. Postoperative IOP elevation in excess of 35 mm Hg at 6 or 24 hours decreased significantly in the preoperative acetazolamide group (3/46 eyes) compared with the control group (14/54 eyes). There was no statistically significant difference in IOP elevation between eyes having extracapsular cataract extraction and those having phacoemulsification, independent of treatment group.

Conclusion: The results favor preoperative acetazolamide to control postcataract IOP elevation. The method of cataract removal did not affect postoperative IOP elevation.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acetazolamide / administration & dosage
  • Acetazolamide / therapeutic use*
  • Administration, Oral
  • Administration, Topical
  • Adrenergic alpha-Agonists / administration & dosage
  • Adrenergic alpha-Agonists / therapeutic use*
  • Aged
  • Carbonic Anhydrase Inhibitors / administration & dosage
  • Carbonic Anhydrase Inhibitors / therapeutic use*
  • Cataract Extraction / adverse effects*
  • Clonidine / administration & dosage
  • Clonidine / analogs & derivatives*
  • Clonidine / therapeutic use
  • Humans
  • Intraocular Pressure / drug effects*
  • Ocular Hypertension / etiology
  • Ocular Hypertension / prevention & control*
  • Prospective Studies


  • Adrenergic alpha-Agonists
  • Carbonic Anhydrase Inhibitors
  • apraclonidine
  • Clonidine
  • Acetazolamide