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Matthew S. Benz, MD; Erika M. Escalona-Benz, MD; Timothy G. Murray, MD; Charles W. G. Eifrig, MD; Daniel M. Yoder, MD; Jeffrey K. Moore, MD; Joyce C. Schiffman, MS

Arch Ophthalmol. 2004;122:705-709.

Objective  To determine whether a single topical aqueous suppressant applied immediately after pars plana vitrectomy with long-acting gas tamponade prevents intraocular pressure (IOP) elevation.

Methods  Fifty patients who met the inclusion criteria and underwent pars plana vitrectomy with long-acting gas tamponade were randomized to receive a combination of timolol maleate and dorzolamide hydrochloride, long-acting timolol alone, dorzolamide alone, or placebo at the conclusion of surgery. The IOP was checked by a portable, handheld tonometer (Tono-Pen) at the conclusion of surgery and at 5 hours, 1 day, and 1 week after surgery.

Results  There were no significant differences in IOP among the groups at the conclusion of surgery. The IOP at 5 hours after surgery (27.0 vs 17.4 mm Hg; P<.001) and 1 day after surgery (26.1 vs 19.9 mm Hg; P = .01) showed a statistically significant difference between the placebo and timolol-dorzolamide groups. The timolol-dorzolamide group showed greater IOP control than either the timolol alone or the dorzolamide alone groups at 5 hours (P = .04 for both).

Conclusion  The use of a single topical aqueous suppressant (timolol-dorzolamide) given after pars plana vitrectomy with long-acting gas tamponade effectively prevents significant postoperative IOP elevation at 5 hours and 1 day after surgery.

From the Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Fla (Drs Benz, Escalona-Benz, Murray, Eifrig, Yoder, and Moore and Ms Schiffman); the Cullen Eye Institute, Baylor College of Medicine, Houston, Tex (Drs Benz and Escalona-Benz); and Retina Associates, PC, Raleigh, NC (Dr Eifrig). The authors have no relevant financial interest in this article.