Safety Alert from Moorfield's Hospital (February 2016)
There have been recent cases in which patients have suffered severe corneal melting following the combined use of acular and maxitrol (dexamethasone and neomycin) after routine cataract surgery. This is a very rare but recognised complication of acular use but it appears that the combination of the two preparations together may significantly increase the risk of corneal melting.
Do not prescribe acular in combination with maxitrol for any patient
Do not use maxitrol routinely for post phaco medication. Follow cataract service guidelines using dexamethasone and chloramphenicol
Be aware that the use of acular is associated rarely with corneal melts and the risk is increased in diabetics and immunocompromised patients
Be vigilant for any corneal melts associated with maxitrol and acular and report them as an incident
FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.
To support the use of PDT with verteporfin for the treatment of Chronic Central Serous Retinopathy.
Approval is subject to patient outcomes being provided (via Blueteq reauthorisation process).
RED - Hospital only – to be prescribed by a specialist and supplied from secondary care ONLY throughout treatment
Amber medicines are considered suitable for GP prescribing following specialist initiation.
These medicines are appropriate for initiation in both primary and secondary care. Prescribing is appropriate within licensed or local recommendations
Shared Care - these medicines require specialist initiation and stabilisation. Ongoing division of responsibility for drug and disease monitoring between specialist and GP by a Shared Care Guideline (SCG). If no SCG in place status reverts to red.
A decision has been made by either or both the local or national NHS not to routinely commission this preparation for its licensed indications. Do not prescribe.