PICO questionWhat are the current NHS national benchmarks for surgical success and complications in patients with COAG undergoing trabeculectomy drainage surgery with and without pharmacological augmentation?
Importance to patients or the populationThis would inform patients of what to expect from their surgery in terms of the chances of success and complications. It would provide more accurate and up to date evidence for surgical treatment in glaucoma.
Relevance to NICEChanges in surgical technique, and therefore success and complication rates, could alter the economic model for glaucoma treatment resulting in potential changes in the NICE recommendations
Relevance to the NHSUp to date information on surgical success and complication rates will provide benchmarks for clinical audit and assist in planning service provision.
National prioritiesNot a national priority in term of NSF or white paper
Current evidence baseCurrent evidence base is the National Audit of Trabeculectomy. This is now 10 years old and techniques have changed. Some surgeons are advocating the use of other surgical techniques such as deep sclerectomy and drainage tube implants. The audit would set a standard against which newer techniques could be evaluated.
Study designThe study design should be the same as the Audit of 10 years ago so we can compare the outcomes now in the light of changes in technique and the recommendations made by that audit.
FeasibilityTechnically, ethically and financially feasible
Other commentsThe research could be facilitated by the Royal College of Ophthalmologists.
The National Institute for Health Research (NIHR) might be a suitable funding source.
The Connecting for Health Information Centre may be a further source of support.
ImportanceHigh. The research is essential to inform future updates of key recommendations in the guideline.

From: Appendix G, Recommendations for research

Cover of Glaucoma
Glaucoma: Diagnosis and Management of Chronic Open Angle Glaucoma and Ocular Hypertension.
NICE Clinical Guidelines, No. 85.
National Collaborating Centre for Acute Care (UK).
Copyright © 2009, National Collaborating Centre for Acute Care.

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