Effect of prophylactic brimonidine on bleeding complications and flap adherence after laser in situ keratomileusis.

Purpose: Several authors have assessed the effect of prophylactic briomonidine on bleeding complications and flap adherence after laser in situ keratomileusis (LASIK). This study further evaluates these potential associations.

Methods: We performed a prospective, double-masked, single-surgeon study of 31 patients (61 eyes) who underwent LASIK with or without prophylactic brimonidine for primary myopia/ myopic astigmatism (59 eyes) or hyperopic astigmatism (2 eyes). Among myopes, mean preoperative sphere was -4.44 +/- 2.21 D and mean cylinder was -1.04 +/- 1.01 D. Thirty-three eyes (54%) had nasal hinges; 28 eyes (46%) had superior hinges.

Results: Subconjunctival hemorrhage was observed in 22 of 61 eyes (36.1%). Three of these 22 eyes (13.6%) received prophylactic brimonidine; the remaining 19 eyes with subconjunctival hemorrhage (86.3%) did not receive brimonidine (P < .0001). All but three eyes had some hyperemia; however, the amount of hyperemia was lower in the brimonidine group (P < .0001). Bleeding from the superior micropannus occurred in four of 61 eyes (6.6%). One of these four eyes received brimonidine. There was one case of flap slippage in a non-brimonidine eye with a nasal hinge; no flap striae were observed after repositioning.

Conclusion: This study suggests that brimonidine administered before LASIK may significantly reduce subconjunctival hemorrhage and reduce the amount of hyperemia.