目的：比较1%布林唑胺和0.5%噻吗洛尔联合制剂(FCBT)与0.5%阿拉可乐定(APRA)滴眼液预防接受Nd：YAG激光晶状体囊切开术患者术后眼压升高的疗效。

方法：前瞻随机对照临床研究。研究包括90例(90眼)接受Nd：YAG激光晶状体囊切开术治疗后囊膜混浊(PCO)患者。患者术前1h随机给予APRA(n=45)或FCBT(n=45)治疗。一名设盲检查者使用Goldmann压平眼压计检查术前及术后1，2，3，24h和7d的眼压。眼压检查结果分为以下两类：术后眼压升高5～<10 mm Hg和眼压升高≥10 mm Hg。眼压升高<5 mm Hg认为没有临床上的显著改变。

结果：APRA组和FCBT组术前当天的平均眼压分别为14.1±2.1 mm Hg和13.2±2.1 mm Hg，差异无统计学意义(P=0.066)。随访期间，FCBT组的平均眼压较低但差异无统计学意义。APRA组中的6名患者(13.3%)和FCBT组中的4名患者(8.9%)术后至少有一次眼压升高5～<10 mm Hg，差异无统计学意义(P=0.243)。眼压升高≥10 mm Hg在APRA 组与FCBT组中分别出现3眼(6.7%)和1眼(2.2%)，差异无统计学意义(P=0.542)。

结论：APRA和FCBT均可有效预防眼压升高且APRA足以应对常规病例。对于需要加强降低眼压的患者-如预先存在青光眼的患者(其术后眼压升高的风险更大)可选择FCBT。

AIM: To compare the efficacy of fixed combination of brinzolamide 1% and timolol 0.5%(FCBT)with apraclonidine 0.5%(APRA)in preventing intraocular pressure(IOP)elevations after neodymium: yttrium-aluminum-garnet(Nd:YAG)laser posterior capsulotomy.

METHODS: This prospective randomized clinical study included 90 eyes of 90 consecutive patients who had Nd:YAG laser posterior capsulotomy for posterior capsule opacification(PCO). Patients were randomized to receive APRA(n=45)or FCBT(n=45)at 1h before laser surgery. A masked observer measured IOP by Goldmann applanation tonometry before the procedure and at 1, 2, 3, 24h and 7d after laser treatment. IOP outcome measures were grouped into the following categories: post laser IOP elevation of 5 to <10 mm Hg, and post laser IOP elevation of 10 mm Hg or more. IOP elevation of <5 mm Hg was not considered a clinically significant change.

RESULTS:The mean IOP before surgery on the day of the procedure was 14.1±2.1 mm Hg in the APRA group and 13.2±2.1 mm Hg in the FCBT group. There was no statistically significant difference between the APRA and the FCBT groups of baseline IOPs measured(P=0.066). During the follow-up time, the mean IOP was lower in FCBT group, but this was not statistically significant. Six patients(13.3%)in APRA group and 4(8.9%)in FCBT group had IOP elevations of 5 to <10 mm Hg at least one postoperative IOP measurement. This difference was not statistically significant(P=0.243). IOP elevations of 10 mm Hg or more occurred in 3 eyes(6.7%)in the APRA group and 1 eyes(2.2%)in the FCBT group; this was not statistically significant(P=0.542).

CONCLUSION:Both of APRA and FCBT are effective for prevention and APRA is enough for most of routine cases. FCBT may be an option for the eyes those need more IOP reduction such as pre-existing glaucoma patients who are at higher risk for postoperative IOP elevations.