J Korean Ophthalmol Soc.  2011 May;52(5):511-518. 10.3341/jkos.2011.52.5.511.

Changes in the Lacrimal Excretory System Depending on the Administration Mode of Brimonidine Tartrate: Spray vs. Irrigation

• Yang HS
• Oh DE

• KMID: 2214568
• DOI: http://doi.org/10.3341/jkos.2011.52.5.511

Abstract

PURPOSE
To investigate the effects of 0.15% brimonidine tartrate ophthalmic solution spray on the luminal changes in the nasolacrimal excretory system.
METHODS
A prospective study was performed on 52 eyes in 26 patients complaining of epiphora in both eyes. The randomly-assigned 26 test eyes (cases) received spray of the solution through the nasal cavity, and the other 26 eyes (controls) were irrigated with the same drug through the inferior calnaliculus. Dacryocystography was then performed to observe the luminal changes jn the nasolacrimal excretory system, patient symptoms and physiologic drainage functions.
RESULTS
The changes in lumen width of the nasolacrimal duct (NLD) were noted, and the changes in lumen width of the lacrimal sac were not significant in either mode. The upper and middle parts of the NLD were widened more in the irrigation group, and the lower part of the NLD was widened more in the spray group. Though there was no significant difference in the physiologic drainage functions, the patients in both groups reported reduced symptoms.
CONCLUSIONS
Brimonidine tartrate spray altered the width of the NLD and improved the subjective symptoms of patients. Therefore, the spray can be applied in functional NLD obstruction patients before the surgical procedure.

Keyword

Brimonidine tartrate; Dacryocystography; Epiphora; Nasolacrimal duct

MeSH Terms

Drainage
Eye
Humans
Lacrimal Apparatus Diseases
Nasal Cavity
Nasolacrimal Duct
Phenobarbital
Prospective Studies
Quinoxalines
Brimonidine Tartrate
Phenobarbital
Quinoxalines

Figure

• 

  Figure 1. (A) The five points at the positive image of dacryocystography. (B) Intense inhancement of intraductal dye contrast (arrowhead) and disconnected area of intraductal flow (arrow) at the negative image of dacryocystography. (C) The laminal flow (arrowhead) is changing into the turbulent flow with multiple air bubbles (arrows) at the transitional zone (box). The distance (about 24.5 mm) between common canaliculus and the fifth point is similar on both sides.

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  Figure 2. Each graph shows luminal changes (mm) in the lacrimal excretory system at 5 points in Alphagan-P® irrigation group and spray group at anteroposterior images.

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  Figure 3. Each graph shows the comparison of the increasing rate (%) of the lumen width at 5 points between in Alphagan-P® irrigation group and spray group at anteroposterior and oblique images. (One way ANOVA test for statistical analysis)

Reference

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