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Topical prostaglandin analogue use and cystoid macular oedema following uneventful cataract surgery: a randomised control trial
  1. Nuwan Niyadurupola,
  2. James Brodie,
  3. Tejal Patel,
  4. Jason Chan,
  5. Mohammad M Rahman,
  6. Carl R Svasti-Salee,
  7. Jared Ching,
  8. Aseema Misra,
  9. Tom Eke,
  10. David C Broadway
  1. Department of Ophthalmology, Norfolk and Norwich University Hospital, Norwich, UK
  1. Correspondence to Nuwan Niyadurupola, Department of Ophthalmology, Norfolk and Norwich University Hospital, Norwich, UK; nuwan.niyadurupola{at}nnuh.nhs.uk

Abstract

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.

  • glaucoma

Data availability statement

Data are available on reasonable request. Deidentified participant data and all relevant data are available from the corresponding author, NN at nuwan.niyadurupola@nnuh.nhs.uk.

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Data availability statement

Data are available on reasonable request. Deidentified participant data and all relevant data are available from the corresponding author, NN at nuwan.niyadurupola@nnuh.nhs.uk.

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Footnotes

  • Contributors DB and NN conceived the idea of the study. NN, DB, TE, JCha and MR planned and designed the study. All authors were involved in data acquisition. NN, TE and DB were involved in analysis and interpretation of data.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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