Topical phenylephrine in laser in situ keratomileusis

Increased risk for flap dislocation with perioperative brimonidine use in femtosecond laser in situ keratomileusis

“…5 There have been attempts to decrease the incidence of subconjunctival hemorrhages through the use of drugs with vasoconstrictive effects, including brimonidine, 6,7 apraclonidine, 8,9 and phenylephrine. 10 However, there is controversial evidence that the use of perioperative vasoconstrictors may increase the incidence of flap complications caused by poor flap adherence. In a retrospective study, Walter and Gilbert 7 found a statistically significant increase in the incidence of a dislocated flap after LASIK with prophylactic brimonidine.…”

Dilute Brimonidine to Improve Patient Comfort and Subconjunctival Hemorrhage After LASIK

“…4 Although these hemorrhages are temporary and without signifi cant visual consequence, reducing or eliminating them provides a more positive patient experience, avoids undue negative psychological effects, and enhances aesthetic outcomes in the procedure with a signifi cant cosmetic component. Topical vasoconstrictors such as brimonidine, [5][6][7][8] apraclonidine, 9 phenylephrine, 10 or combined naphazoline/pheniramine eye drops 11 help reduce postoperative subconjunctival hemorrhage, injection, and hyperemia. However, the use of these medications has been avoided due to the possibility that they may increase the incidence of fl ap dislocations 8 and the frequency of surgical enhancements.…”