{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T19:48:05Z","timestamp":1786736885736,"version":"build-2736575974"},"reference-count":0,"publisher":"GN1 Sistemas e Publicacoes Ltd.","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ABO"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:p>Purpose: To assess whether low-concentration brimonidine (0.025%) improves early postoperative\nsigns and symptoms following femtosecond laser-assisted in situ keratomileusis and photorefractive\nkeratectomy without affecting pupil diameter or flap safety. Methods: This prospective, randomized,\ndouble-masked, contralateral-eye, single-center study was conducted between January and September\n2024. In each patient, one eye received 0.025% brimonidine 15\u201330 min before surgery (mean: 21.3 \u00b1\n2.4 min), whereas the fellow eye received 0.15% sodium hyaluronate (control). Primary outcomes on\npostoperative Day 1 included subconjunctival hemorrhage laser-assisted in situ keratomileusis and\npatient-reported symptoms (0\u201310 scale; composite score). Pupil diameter was measured pre-ablation.\nStatistical analyses included McNemar and paired t tests, with a significant threshold of \u03b1=0.05. Results:\nA total of 124 patients were included (54 laser-assisted in situ keratomileusis and 70 photorefractive\nkeratectomy). Pupil diameter did not differ significantly between brimonidine-treated and control\neyes (laser-assisted in situ keratomileusis: 2.63 \u00b1 0.47 vs. 2.69 \u00b1 0.42 mm, p=0.273; photorefractive\nkeratectomy: 2.56 \u00b1 0.44 vs. 2.61 \u00b1 0.39 mm, p=0.116). In laser-assisted in situ keratomileusis, subconjunctival\nhemorrhage occurred less frequently in brimonidine-treated eyes both intraoperatively (9.3%\nvs. 46.3%, p&lt;0.001) and on postoperative Day 1 (9.3% vs. 50.0%, p&lt;0.001). Composite symptom scores\nwere significantly lower in brimonidine-treated eyes in both laser-assisted in situ keratomileusis and\nphotorefractive keratectomy groups (p=0.001 for both). Conclusions: Preoperative administration\nof low-concentration brimonidine (0.025%) significantly reduced subconjunctival hemorrhage in\nlaser-assisted in situ keratomileusis without comprising flap integrity. It also improved early\npostoperative symptoms in laser-assisted in situ keratomileusis and photorefractive keratectomy,\nwithout affecting pupil diameter. These findings support the use of dilute brimonidine as a safe and\neffective adjunct to enhance the immediate postoperative experience in refractive surgery.<\/jats:p>","DOI":"10.5935\/0004-2749.2025-0330","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T18:47:20Z","timestamp":1786733240000},"page":"1-8","source":"Crossref","is-referenced-by-count":0,"title":["Diluted brimonidine for improving early postoperative symptoms and subconjunctival hemorrhage after PRK and LASIK"],"prefix":"10.5935","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1223-3691","authenticated-orcid":false,"given":"Nat\u00e1lia Fernandes Gon\u00e7alves","family":"Napolitano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7686-6781","authenticated-orcid":false,"given":"Ana Vega Carreiro","family":"de Freitas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5659-7693","authenticated-orcid":false,"given":"Lu\u00eds Gustavo de Imparato Rodrigues","family":"Ribeiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9375-5061","authenticated-orcid":false,"given":"Daniella Villas Boas","family":"Fairbanks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando Antonio Galhardo","family":"Tarcha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2342-8638","authenticated-orcid":false,"given":"Vagner Loduca","family":"Lima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4441-4304","authenticated-orcid":false,"given":"Bernardo Kaplan","family":"Moscovici","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4243-8805","authenticated-orcid":false,"given":"Edmundo Jos\u00e9 Velasco","family":"Martinelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3948","published-online":{"date-parts":[[2026]]},"container-title":["Arquivos Brasileiros de Oftalmologia"],"original-title":[],"link":[{"URL":"https:\/\/www.scielo.br\/j\/abo\/a\/cSpq4shbQxJQ7Xm6vNNRzNb\/?lang=en&ilang=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T18:47:22Z","timestamp":1786733242000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.scielo.br\/j\/abo\/a\/cSpq4shbQxJQ7Xm6vNNRzNb\/?lang=en&ilang=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":0,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026]]},"published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.5935\/0004-2749.2025-0330","relation":{},"ISSN":["0004-2749"],"issn-type":[{"value":"0004-2749","type":"print"}],"subject":[],"published":{"date-parts":[[2026]]}}}