Topical prostaglandin analogue use and cystoid macular oedema following uneventful cataract surgery: a randomised control trial.


Journal

The British journal of ophthalmology
ISSN: 1468-2079
Titre abrégé: Br J Ophthalmol
Pays: England
ID NLM: 0421041

Informations de publication

Date de publication:
12 2022
Historique:
received: 22 02 2021
accepted: 16 05 2021
pubmed: 29 5 2021
medline: 25 11 2022
entrez: 28 5 2021
Statut: ppublish

Résumé

The association between the development of cystoid macular oedema (CMO) following uneventful cataract surgery and prostaglandin analogue (PGA) therapy has not been fully determined. The study aim was to investigate whether discontinuation of PGA therapy following uneventful cataract surgery affected the incidence of postoperative CMO. A prospective randomised controlled trial of 62 eyes of 62 participants with ocular hypertension (OH) or primary open angle glaucoma (POAG) treated with PGAs prior to cataract surgery. Participants were randomised to continue with PGA therapy after cataract surgery (CPGA) (n=31) or to discontinue PGA therapy (n=31). The primary outcome measure was the development of CMO at 1-month postoperatively, determined by a masked observer assessment of optical coherence tomography scans. The secondary outcome measure was change from baseline intraocular pressure (IOP). The incidence of CMO was identical in both groups at 12.9% (4 of 31 eyes) at the 1-month postoperative visit (OR 1.000; 95% CI 0.227 to 4.415). At 1-month postoperatively, the IOP was significantly lower in the CPGA group compared with baseline IOP. Continuation of PGA therapy following uneventful cataract surgery in eyes with normal macular morphology did not increase the incidence of CMO. Continuation of PGA therapy significantly reduced IOP at 1-month postoperatively suggesting that, when indicated, it might be beneficial to continue PGA therapy in patients with POAG or OH after uneventful cataract surgery in the absence of other risk factors for developing CMO.

Sections du résumé

BACKGROUND/AIMS
The association between the development of cystoid macular oedema (CMO) following uneventful cataract surgery and prostaglandin analogue (PGA) therapy has not been fully determined. The study aim was to investigate whether discontinuation of PGA therapy following uneventful cataract surgery affected the incidence of postoperative CMO.
METHODS
A prospective randomised controlled trial of 62 eyes of 62 participants with ocular hypertension (OH) or primary open angle glaucoma (POAG) treated with PGAs prior to cataract surgery. Participants were randomised to continue with PGA therapy after cataract surgery (CPGA) (n=31) or to discontinue PGA therapy (n=31). The primary outcome measure was the development of CMO at 1-month postoperatively, determined by a masked observer assessment of optical coherence tomography scans. The secondary outcome measure was change from baseline intraocular pressure (IOP).
RESULTS
The incidence of CMO was identical in both groups at 12.9% (4 of 31 eyes) at the 1-month postoperative visit (OR 1.000; 95% CI 0.227 to 4.415). At 1-month postoperatively, the IOP was significantly lower in the CPGA group compared with baseline IOP.
CONCLUSION
Continuation of PGA therapy following uneventful cataract surgery in eyes with normal macular morphology did not increase the incidence of CMO. Continuation of PGA therapy significantly reduced IOP at 1-month postoperatively suggesting that, when indicated, it might be beneficial to continue PGA therapy in patients with POAG or OH after uneventful cataract surgery in the absence of other risk factors for developing CMO.

Identifiants

pubmed: 34045222
pii: bjophthalmol-2021-319149
doi: 10.1136/bjophthalmol-2021-319149
doi:

Substances chimiques

Prostaglandins A 0
Prostaglandins, Synthetic 0

Types de publication

Randomized Controlled Trial Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1662-1666

Informations de copyright

© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Nuwan Niyadurupola (N)

Department of Ophthalmology, Norfolk and Norwich University Hospital, Norwich, UK nuwan.niyadurupola@nnuh.nhs.uk.

James Brodie (J)

Department of Ophthalmology, Norfolk and Norwich University Hospital, Norwich, UK.

Tejal Patel (T)

Department of Ophthalmology, Norfolk and Norwich University Hospital, Norwich, UK.

Jason Chan (J)

Department of Ophthalmology, Norfolk and Norwich University Hospital, Norwich, UK.

Mohammad M Rahman (MM)

Department of Ophthalmology, Norfolk and Norwich University Hospital, Norwich, UK.

Carl R Svasti-Salee (CR)

Department of Ophthalmology, Norfolk and Norwich University Hospital, Norwich, UK.

Jared Ching (J)

Department of Ophthalmology, Norfolk and Norwich University Hospital, Norwich, UK.

Aseema Misra (A)

Department of Ophthalmology, Norfolk and Norwich University Hospital, Norwich, UK.

Tom Eke (T)

Department of Ophthalmology, Norfolk and Norwich University Hospital, Norwich, UK.

David C Broadway (DC)

Department of Ophthalmology, Norfolk and Norwich University Hospital, Norwich, UK.

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Classifications MeSH