Efficacy of Brimonidine Tartarate 0.2% Ophthalmic Solution on Reducing Night Vision Difficulty and Improving Contrast Sensitivity After Laser in Situ Keratomileusis

Abstract Background The relation between scotopic pupil diameter and the optical zone is the most important factor in limiting night vision disturbances after LASIK. Brimonidine Tartrate is a selective alpha-2 agonist which significantly reduces scotopic pupil diameter. It can be used to improve contrast sensitivity and night vision after refractive procedures. Objective Subjective and objective evaluation of the effect of Brimonidine tartrate 0.2% ophthalmic solution on improving post-LASIK night vision complaints by studying its effect on the pupil diameter, contrast sensitivity, aberrations and symptoms of night vision difficulties. Patients and Methods This prospective study was conducted upon 34 eyes of 17 patients suffering from night vision difficulties after uneventful lasik surgery. They received one drop of Brimonidine Tartrate 0. 2% ophthalmic solution on each eye and were asked to apply one drop in each eye daily for two months. Testing was performed before drops instillation, 30 minutes, 4 hours after instillation and after 2 months of regular brimonidine use. All patients had photopic and scotopic pupillometry using Zywave aberrometer built in pupillometer, Contrast sensitivity testing using Pelli-Robson chart, Aberrometry using Zywave aberrometer. Visual night complaints was assessed with an FDA approved questionnaire taken from (LASIK quality of life collaboration project). Results There was a significant decrease in mean photopic and scotopic pupil diameter, spherical and total aberrations after 30 minutes, 4 hours and 2 month of once daily use of Brimonidine. Also there was a significant improvement of contrast sensitivity that remained at acceptable levels along the follow up time. All patients showed a significant visual satisfaction after 2 month of treatment. Conclusion Brimonidine tartrate 0. 2% ophthalmic solution can be effective in reducing night vision difficulties after LASIK by reducing scotopic pupil diameter, improving contrast sensitivity and decreasing higher order aberrations.