Issues for Surgery |
For primary open-angle glaucoma (topical) – increased risk of deterioration in eyesight if omitted for a prolonged period. |
Advice in the Perioperative period |
Elective and Emergency Surgery Continue including the following combination products (unless the patient is undergoing ophthalmology surgery and the Ophthalmologist requests for them to be withheld): -
Confirm with patient if drops are prescribed for left eye, right eye or both eyes. Encourage correct application technique to reduce systemic absorption (see Further Information). Post-operative Advice Restart post-operatively when next dose is due (unless the patient has undergone ophthalmology surgery and the Ophthalmologist requests for them to be withheld). |
Interaction(s) with Common Anaesthetic Agents |
None 1, 2, 3, 4, 5, 6 as systemic concentrations of prostaglandin analogues are extremely low following ocular dosing 3, 4. For combination products Systemic absorption can follow topical application of beta-blockers to the eyes 1 – the advice and cautions as listed for systemic beta-blockers should be considered (see Beta-adrenoceptor Blockers (Beta-Blockers) (Systemic and Topical) monograph). |
Interaction(s) with other Common Medicines used in the Perioperative Period |
None expected1, 3, 4, 5, 6 as systemic concentrations of prostaglandin analogues are extremely low following ocular dosing3, 4. However variable effects on the intraocular pressure-lowering effects of some ophthalmic prostaglandin analogues have been seen with various Non-Steroidal Anti-inflammatory Drugs (NSAIDs) in a small study. Whilst short term use post-operatively should not pose a problem, if long term use is necessary discuss with an Ophthalmologist as additional monitoring might be appropriate when an oral or ocular NSAID is stopped or started in a patient stabilised on an ophthalmic prostaglandin analogue 2. For combination products Systemic absorption can follow topical application of beta-blockers to the eyes 1 – the advice and cautions as listed for systemic beta-blockers should be considered (see Beta-adrenoceptor Blockers (Beta-Blockers) (Systemic and Topical) monograph). |
Further Information |
Systemic Absorption Nasolacrimal occlusion or gently closing the eyelid is recommended following ocular administration of any medication to reduce systemic absorption 4, 5, 6. |
References |
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