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May 20, 2020
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Brimonidine 0.15% can significantly reduce subconjunctival hemorrhage after FLACS

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Patients who received one preoperative drop of Alphagan P experienced significantly less bulbar redness after femtosecond laser-assisted cataract surgery compared with patients who received only traditional preoperative eye drops, according to a speaker at the virtual American Society of Cataract and Refractive Surgery meeting.

“This is the first study to evaluate brimonidine’s effect on subconjunctival hemorrhage following FLACS, and we also were able to objectively quantify subconjunctival hemorrhage,” Eric S. Tam, MD, FRCSC, said.

Tam and colleagues evaluated the preoperative and postoperative bulbar redness scores in patients who underwent femtosecond laser-assisted cataract surgery (FLACS) who received traditional preoperative eye drops or traditional drops plus an additional drop of Alphagan P (brimonidine tartrate 0.15%, Allergan). All patients underwent baseline preoperative imaging with the Keratograph 5M (Oculus) and postoperative imaging 15 minutes after the completion of the procedure.

The masked prospective randomized controlled study included 25 patients who received brimonidine and 37 patients in the control group. Preoperatively, brimonidine patients had a mean bulbar redness score of 1.62 compared with 1.40 in control group patients.

Postoperatively, brimonidine patients experienced a mean decrease of 0.21 in bulbar redness score compared with an increase of 0.06 in the control group, a statistically significant difference (P = .03), Tam said.

“Although the difference in bulbar redness scores was not statistically significant between the two groups preop or postop, the change was statistically significant,” he said.

Postoperative images of the control eyes showed more subconjunctival hemorrhage in the shape of a ring consistent with the suction cup applied during FLACS, he said.