The Use of punctal plugs in glaucoma
Research type
Research Study
Full title
A prospective cohort study to assess the effect of punctal plugs in participants with glaucoma and ocular surface disease using prostaglandin analogues.
IRAS ID
163109
Contact name
John Salmon
Contact email
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Glaucoma afflicts 67 million people world-wide. In patients with primary open angle glaucoma (POAG) first line treatment is medical therapy. Most patients require life long therapy to lower the eye pressure, usually in the form of eye drops. Prostaglandin analogues (PGA) are the first therapy in the UK as per the National Institute of Clinical Excellent Glaucoma Guidelines. Even those who have glaucoma surgery may require additional eye drops.
Ocular surface disease (OSD) is a multi-factorial condition. OSD causes a significant deterioration of quality of life and affects many activities of daily life. Approximately 15% of the general elderly population experiences some level of ocular surface disease. Patients with ocular hypertension and POAG have been shown to suffer from ocular surface disease in a higher prevalence than in the normal population.
Various studies have shown occluding the puncta or nasolacrimaducts can either temporarily or permanently improve the ocular surface.
The purpose of our study is to establish the objective and subjective effect of a lower punctal plug (PP) in participants with established ocular surface disease using a PGA, with or without preservative.
The effect of the PP on the intraocular pressure (IOP) will also be assessed.
Participants from glaucoma clinic in Oxford Eye Hospital willing to be involved will have subjective evidence of OSD as evidenced by the OSDI will attend a clinic review where the tear osmolality, tear-film break up time (TFBUT), IOP, and OGS will be assessed. A PP will be inserted in one lower tear duct. The same assessment will be carried out 6 weeks later, and the participant will be offered a punctal plug in the other lower puntum or the removal of the existing punctual plug. The duration of the study is anticipated to be 6 - 12 months including analysis and write up.REC name
South Central - Oxford C Research Ethics Committee
REC reference
15/SC/0162
Date of REC Opinion
12 Mar 2015
REC opinion
Favourable Opinion