Dilute Brimonidine to Improve Patient Comfort and Subconjunctival Hemorrhage After LASIK

Pasquali, Theodore; Aufderheide, Adam; Brinton, Jason Philip; Avila, Michele R.; Stahl, Erin D.; Durrie, Daniel S.

doi:10.3928/1081597x-20130617-05

Cited by 16 publications

(25 citation statements)

References 16 publications

(27 reference statements)

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“…Hosten and Snyder Clinical doses (0.025%). [27][28][29] Brimonidine, in an ophthalmic solution with the lower concentration of 0.025%, received FDA approval in 2017 to reduce the redness of the eye due to minor irritations.…”

Section: Dovepressmentioning

confidence: 99%

<p>Over-the-Counter Ocular Decongestants in the United States – Mechanisms of Action and Clinical Utility for Management of Ocular Redness</p>

Hosten¹,

Snyder²

2020

OPTO

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To manage ocular redness effectively, health-care practitioners require an understanding of the pathophysiology, clinical features and differential diagnosis of ocular redness, as well as comprehensive knowledge of medical therapies available and their pharmacologic properties. This review aims to provide a clinically relevant summary of the current literature on the mechanism of action, efficacy, and safety of current over-the-counter (OTC) decongestants available for reduction of ocular redness due to minor irritations. Currently marketed OTC products indicated for such use in the United States include topical solutions of tetrahydrozoline 0.05%, naphazoline 0.012% to 0.03%, and brimonidine 0.025%. All 3 agents are adrenergic receptor agonists but vary in their receptor-binding profiles: tetrahydrozoline is a selective α1 receptor agonist; naphazoline is a mixed α1/α2 receptor agonist; and brimonidine is a selective α2 receptor agonist. These OTC decongestants produce vasoconstriction of conjunctival blood vessels, which results in a rapid reduction in ocular redness. In general, ocular adverse events reported in published studies of these OTC decongestants were minimal, mild, and transient, with no significant adverse systemic effects. However, ocular decongestants with α1-adrenergic receptor agonist activity can be associated with loss of effectiveness with continued use (ie, tachyphylaxis) and rebound redness upon treatment discontinuation. In clinical trials of the selective α2-adrenergic receptor agonist brimonidine 0.025%, tachyphylaxis was not observed, and rebound redness was rarely reported.

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Section: Dovepressmentioning

confidence: 99%

<p>Over-the-Counter Ocular Decongestants in the United States – Mechanisms of Action and Clinical Utility for Management of Ocular Redness</p>

Hosten¹,

Snyder²

2020

OPTO

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“…4 The use of brimonidine in dermatologic surgery, however, has not been reported until now. 4 The use of brimonidine in dermatologic surgery, however, has not been reported until now.…”

Section: Discussionmentioning

confidence: 99%

Topical Brimonidine Gel as a Hemostatic Agent After Dermatologic Surgery

Schleichert

Weiss

2015

Dermatologic Surgery

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“…17 Preoperative brimonidine 0.2% has been associated with rates of flap striae or dislocation as high as 12.8% 18,19 ; in other studies, neither brimonidine 0.2%, dilute brimonidine, nor apraclonidine have been associated with flap adherence issues. [20][21][22] Femtosecond flaps have been shown in a rabbit model to have stronger adhesion strength than microkeratome flaps, although this may have more bearing on late dislocation rather than early dislocation. 23 Meticulous examination to evaluate for flap striae or displacement should occur on the first postoperative day.…”

Section: ' Introductionmentioning

confidence: 99%

LASIK Flap

Estopinal¹

2016

International Ophthalmology Clinics

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Laser-assisted in situ keratomileusis (LASIK) surgery is among the most common operations in the world. It is estimated that over 15 million patients have undergone LASIK, and approximately 95% of these patients are satisfied after their operation. 1 Advances in instrumentation, such as the introduction of femtosecond laser technology for flap creation, have improved the predictability of creating flaps and safety profile of LASIK surgery. 2-4 The LASIK flap allows for rapid visual recovery with minimal pain 5 ; however, LASIK flap-associated postoperative complications do occur. Overall complication rates are low, with several large series reporting complication rates of <1% to 1.8%, which tend to decrease with surgeon experience. 6-9 Post-LASIK flap-related complications can be organized into early postoperative complications, occurring within 72 hours of the operation, and late postoperative complications, occurring Z72 hours after the operation (Table 1). Given the low but real risk of postoperative flap complications, it is imperative that the refractive surgeon is well versed in the diagnosis and management of postoperative complications associated with the LASIK flap. ' Early Postoperative Complications Mechanical Flap Complications: Flap Striae and DisplacementThe LASIK flap can be wrinkled or displaced postoperatively, most commonly presenting on the first postoperative day. LASIK flap striae occur when the flap has folds in itself, usually because of initial misalignment of the flap, small movements of the flap, or ''tenting'' of

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Dilute Brimonidine to Improve Patient Comfort and Subconjunctival Hemorrhage After LASIK

Abstract: Use of dilute brimonidine before LASIK reduces subconjunctival hemorrhage and injection and improves patient comfort after surgery. Flap edge wrinkling requiring refloat may still be a complication with dilute brimonidine.

Cited by 16 publications

References 16 publications

<p>Over-the-Counter Ocular Decongestants in the United States – Mechanisms of Action and Clinical Utility for Management of Ocular Redness</p>

<p>Over-the-Counter Ocular Decongestants in the United States – Mechanisms of Action and Clinical Utility for Management of Ocular Redness</p>

Topical Brimonidine Gel as a Hemostatic Agent After Dermatologic Surgery

LASIK Flap

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