Brimonidine tartrate 0.15% drops to reduce low post-LASIK residual myopia: A retrospective study

Abstract

Purpose: Residual myopia following Laser-assisted in situ keratomileusis (LASIK) surgery poses a significant concern, with existing literature extensively detailing the use of timolol for treatment. This study aims to assess prediction factors for brimonidine tartrate 0.15% (Alphagan-P) response on post-LASIK residual myopic refraction reduction.

Methods: The study included consecutive patients who received Alphagan-P during their follow-up for post-LASIK residual myopia.

Results: We included 61 patients (55% male) with a mean age of 35.18 ± 10.13 Alphagan-P Treatment started at a mean of 4.94 ± 5.64 months after surgery for residual myopia of -0.53 ± 0.71D. Comparison analysis of patients who responded (n = 32, 51.6%) to patients who did not (n = 30, 48.4%) shows that responders were older (38.1 ± 9.1 vs. 32.3 ± 10.3, p = 0.03), had higher baseline myopic Spherical equivalent (SE, -0.82 ± 0.65 vs. -0.26 ± 0.66 p < 0.01), and lower uncorrected visual acuity (Uncorrected visual acuity [UCVA], 0.14 ± 0.2 vs. -0.003 ± 0.12 p = 0.01). Multiple Binary logistic regression confirmed these predictors for response (UCVA (OR=70.6, P = .006), larger SE (OR=3.8, P = .004,) and older age (OR=1.06, P = .03)).

Conclusions: Alphagan-P can reduce up to 0.5D of post-LASIK residual myopia in roughly 50% of subjects. This treatment might be recommended to fine-tune outcomes for low residual myopia.

Fig 1. (1) The combination treatment effect of IOP-10 lowering with the rearward displacement of the cornea and flattening of its curvature. (2) The pinhole effect through miosis promotes depth of focus. This results in halo reductions, improved night vision and contrast, and reduced discomfort and subconjunctival hemorrhage.