netFormulary

North East and North Cumbria
ICS Formulary

11 Eye

Preservative Free Eye Drops
Microbial contamination of multidose bottles of eye drops can cause eye infections that may lead to damage of the eye and in extreme cases loss of sight. To minimise the risk, multidose bottles of eye drops contain an antimicrobial preservative such as benzalkonium chloride. The preservatives used in eye drops are normally well tolerated, but they are not completely harmless. They can cause irritation and damage to the corneal epithelium. This risk is understood to be greater in patients with pre-existing damage to the ocular surface and where large quantities of preservative containing eye drops are applied repeatedly over a prolonged period (e.g. if applied more than 4 to 6 times daily for several weeks/ months).
To avoid these problems the use of preservative-free eye drops is recommended in:
 Patients who have experienced hypersensitivity reactions or irritation due to preservatives in eye drops.
 Patients who have received corneal grafts.
 Patients with conditions where there is already damage to the ocular surface as a result of disease or trauma, such as dry eye, blepharitis, ocular burns etc.
Treatment with preservative-free eye drops will usually be initiated by an ophthalmologist.

11-08-02 Subfoveal choroidal neovascularisation

Aflibercept Eylea^®

Formulary

40mg/1ml & 114.3mg/1ml solution for injection
Approved for wet age related macular degeneration in line with NICE.
Approved for macular oedema – central retinal vein occlusion in line with NICE.
Approved for diabetic macular oedema in line with NICE.
Approved for treating visual impairment caused by macular oedema after branch retinal vein occlusion in line with NICE.
Approved as an option for treating visual impairment because of myopic choroidal neovascularisation in adults in line with NICE

NICE TA 294 Aflibercept solution for injection for treating wet age‑related macular degeneration

NICE TA 305 Aflibercept for treating visual impairment caused by macular oedema secondary to central retinal vein occlusion

NICE TA 346 Aflibercept for treating diabetic macular oedema

NICE TA 409: Aflibercept for treating visual impairment caused by macular oedema after branch retinal vein occlusion

NICE TA 486: Aflibercept for treating choroidal neovascularisation

Brolucizumab Beovu^®

Formulary

19.8mg/0.165mL solution for injection (pre-filled syringes)
- Approved for treating wet age-related macular degeneration in adults in line with NICE

MHRA Drug Safety Update (Jan 2022): Brolucizumab (Beovu▼): risk of intraocular inflammation and retinal vascular occlusion increased with short dosing intervals

NICE TA672: Brolucizumab for treating wet age-related macular degeneration

NICE TA820: Brolucizumab for treating diabetic macular oedema

Faricimab Vabysmo^®

Formulary

120mg/1ml solution for injection
- Approved for the treatment of diabetic macular oedema in adults in line with NICE
- Approved for the treatment of wet age-related macular degeneration in line with NICE
- Approved for the treatment of visual impairment caused by macular oedema after retinal vein occlusion in line with NICE

NICE TA799: Faricimab for treating diabetic macular oedema

NICE TA800: Faricimab for treating wet age-related macular degeneration

TA1004: Faricimab for treating visual impairment caused by macular oedema after retinal vein occlusion

Ranibizumab 10mg/1ml injection Lucentis^®

Formulary

Approved for wet age related macular degeneration in line with NICE.
Approved for diabetic macular oedema in line with NICE.
Approved for visual impairment caused by macular oedema secondary
to retinal vein occlusion in line with NICE.
Approved as a possible treatment for sight problems caused by choroidal neovascularisation in people who also have pathological myopia in line with NICE.

NICE TA 274 Ranibizumab for treating diabetic macular oedema

NICE TA 155 Ranibizumab and pegaptanib for the treatment of age-related macular degeneration

NICE TA 283 Ranibizumab for treating visual impairment caused by macular oedema secondary to retinal vein occlusion

NICE TA 298 Ranibizumab for treating choroidal neovascularisation associated with pathological myopia

Verteporfin 15mg Injection Visudyne^®

Formulary

Approved for photodynamic therapy in wet age-related macular degeneration in line NICE.

NICE NG82: Age-related macular degeneration

NTAG Decision Summary June 2020: Verteporfin

Bevacizumab 1.25mg/0.5ml intravitreal injection

Formulary

NETAG approved for use in the management of macular oedema
secondary to retinal vein occlusion. This is considered a more cost
effective treatment option in RVO compared with ranibizumab.

NTAG approved for age related macular degeneration.

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