CMO incidence following cataract surgery continuing/stopping PGA drops

  • Research type

    Research Study

  • Full title

    A randomised control study to investigate if the continuation of prostaglandin analogue treatments in the post-operative phase of glaucoma patients undergoing cataract surgery increases the incidence of cystoid macular oedema on ocular coherence tomography.

  • IRAS ID

    147580

  • Contact name

    Nuwan Niyadurupola

  • Contact email

    Nuwan.Niyadurupola@nnuh.nhs.uk

  • Sponsor organisation

    Norfolk & Norwich University Hospital

  • Duration of Study in the UK

    0 years, 6 months, 1 days

  • Research summary

    Glaucoma is a common condition in which the eye’s nerve that sends images to the brain becomes damaged- most often associated with high pressure in the eye.
    The commenest treatment for glaucoma is the use of prostaglandin analogue (PGA) eyedrops to reduce the pressure in the eye and slow its progression.
    After cataract surgery, all patients administer anti-inflammatory eye drops to help the eye settle. In cataract surgery for someone already taking a PGA drop, some glaucoma specialists stop the PGA drop whilst others continue them.
    Some decide to stop the PGA drop because of reports of greater risk of developing swelling at the back of the eye (cystoid macular oedema), which can temporarily reduce the vision. These one-off reports that do not represent scientifically significant numbers considering the huge number of people that take these drops.
    So is it better to stop the PGA drop because of a potential risk of causing of swelling at the back of the eye? Or is it better to prioritise lower pressures to prevent the glaucoma getting worse?
    We do not know which approach is best for patients, therefore we need to make a comparison. In this study, glaucoma patients on a PGA drop undergoing cataract surgery will be randomly chosen to either stop or continue their PGA drop. All participants after cataract surgery will be given the standard post-operative anti-inflammatory drop.
    After the operation, we will look for early signs of macula swelling with ocular coherence tomography (OCT), a non-invasive scan of the eye used routinely in eye clinics, that just takes a few minutes of time during the visit.
    We hope to answer the common clinical dilemma of whether prostaglandin analogue eyedrops should continue in the immediate postoperative period of cataract surgery in patients already taking these drops for their glaucoma.

  • REC name

    East of England - Cambridgeshire and Hertfordshire Research Ethics Committee

  • REC reference

    15/EE/0239

  • Date of REC Opinion

    8 Aug 2016

  • REC opinion

    Further Information Favourable Opinion