Effect of prophylactic brimonidine instillation on bleeding during strabismus surgery in adults

PURPOSE: To investigate the effects of preoperative brimonidine-purite 0.15% instillation on intraoperative bleeding and postoperative subconjunctival hemorrhage during strabismus surgery in adult patients. DESIGN: Randomized comparative interventional case series. METHODS: One hundred and eighteen eyes of 90 consecutive adult patients were instilled with either a single drop of brimonidine-purite 0.15% (42 eyes), phenylephrine 1% (38 eyes), or sodium hyaluronate 0.1% (38 eyes) 15 minutes prior to strabismus surgery. Intraoperative bleeding and postoperative subconjunctival hemorrhage were graded on a scale of one to three. The scores were compared among the study groups. RESULTS: Scores of the intraoperative bleeding and the postoperative subconjunctival hemorrhage of the treatment groups were significantly less than that of the control group (P < .001). The scores of the brimonidine group were similar to those of the phenylephrine group (intraoperative bleeding score, P = .405; subconjunctival hemorrhage score, P = .722). CONCLUSIONS: Topical brimonidine administration before strabismus surgery may reduce intraoperative bleeding and postoperative subconjunctival hemorrhage in adult patients.