Mannitol Infusion to Reduce Intraocular Pressure

In 1904, Cantonnet recommended lessubstances osmotiques(sodium chloride, lactose) in the treatment of glaucoma.1Since then a number of osmotic agents have been used, with more or less success, to lower both cerebrospinal fluid pressure and intraocular pressure.2-4Recently, intravenous hypertonic urea has been effectively used.5,6 Mannitol, a 6-carbon hexahydric alcohol, has been employed fairly extensively as an osmotic diuretic.7,8Recent experimental and clinical studies have demonstrated that hypertonic mannitol solutions are effective in lowering cerebrospinal fluid pressure and decreasing brain mass.9,12,20Mannitol is stable in solution, inert, and nontoxic, and its distribution is limited to the extracellular fluid compartment.8-10These facts indicated that hypertonic mannitol might be an excellent agent for the reduction of intraocular pressure. Methods and Materials Ten consecutive patients who received mannitol infusions are included in this study. The group is comprised of 2 patients from the neurosurgical service