Journal List > J Korean Ophthalmol Soc > v.52(5) > 1009027

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

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 ran-domly-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.

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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.
jkos-52-511f1.tif
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.
jkos-52-511f2.tif
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)
jkos-52-511f3.tif
Table 1.
The characteristics of patients
Irrigation (mean ± SD, n = 24) Spray (mean ± SD, n = 24) p-value*
Age (yr, average) 63.5 ± 7.5
Sex (M/F) 22/2
Intensity of symptoms (point, 1-5) 2.9 ± 1.8 2.8 ± 1.6 0.424
Duration of symptoms (point, 1-5) 3.2 ± 1.0 3.3 ± 1.3 0.091
Schirmer I test 13.7 ± 3.0 14.1 ± 4.0 0.062
Dye disappear test 2.0 ± 0.3 2.1 ± 0.3 0.103

* t-test.

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