Table 4.
Quality assessment and summary of findings.
| Outcomes |
Number of participants (studies) Follow-up |
Quality of the evidence (GRADE) |
Relative effect (95% CI) |
Anticipated absolute effects | |
|---|---|---|---|---|---|
| Risk with bilateral surgery on different days | Risk difference with immediate sequential bilateral cataract surgery (95% CI) | ||||
| Any postoperative complications | 2613 (2 studies) |
⊕⊕⊝⊝ Low 1,2 Due to risk of bias and inconsistency |
RR 0.76
(0.55 to 1.07) |
142 per 1000 | 34 fewer per 1000 (from 64 fewer to 10 more) patients were diagnosed with any postoperative complication in the ISBCS group |
|
| |||||
| Serious postoperative complications | 2613 (2 studies) |
⊕⊝⊝⊝ Verylow 1,2,3 Due to risk of bias, inconsistency, and imprecision |
RR 1.63
(0.55 to 4.78) |
9 per 1000 | 6 more per 1000 (from 4 fewer to 35 more) were diagnosed with a serious postoperative complication in the ISBCS group |
|
| |||||
| Subjective visual function test (VF-7 or VF-14 questionnaire) |
2096 (2 studies) |
⊕⊕⊕⊝ Moderate 1 Due to risk of bias |
The mean subjective visual function (VF-7 or VF-14 questionnaire) was 0.01 standard deviations higher (0.47 lower to 0.48 higher) in the group randomized to ISBCS | ||
The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; RR: risk ratio; ISBCS: immediate sequential bilateral cataract surgery; VF: visual function.
GRADE working group grades of evidence are as follows.
High quality: further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: we are very uncertain about the estimate.
1Studies were not blinded to outcome assessment.
2Very large differences between studies in the reported rates of complications.
3Studies do not have the sufficient size to reliably assess the number of serious but rare complications (e.g., endophthalmitis).