Summary of findings for the main comparison. Nd:YAG laser compared to argon‐green laser for proliferative diabetic retinopathy.
| Nd:YAG laser compared to argon‐green laser for proliferative diabetic retinopathy | ||||||
| Patient or population: people with proliferative diabetic retinopathy Setting: eye hospital Intervention: Nd:YAG laser Comparison: argon‐green laser | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with argon‐green laser | Risk with Nd:YAG laser | |||||
| BCVA: loss of 15 or more ETDRS letters follow‐up: 1 year | Study population | RR 0.80 (0.30 to 2.13) | 20 (1 RCT) | ⊕⊝⊝⊝ VERY LOW 1 2 3 | ||
| 500 per 1000 | 400 per 1000 (150 to 1000) | |||||
| BCVA: gain of 15 or more ETDRS letters | Study population | RR 0.33 (0.02 to 7.32) | 20 (1 RCT) | ⊕⊝⊝⊝ VERY LOW 1 2 3 | ||
| 100 per 1000 | 33 per 1000 (2 to 732) | |||||
| Progression of PDR follow‐up: 1 year | Study population | RR 1.00 (0.07 to 14.95) | 42 (1 RCT) | ⊕⊝⊝⊝ VERY LOW 1 2 4 | ||
| 48 per 1000 | 48 per 1000 (3 to 712) | |||||
| Regression of PDR follow‐up: 1 year | Study population | RR 1.00 (0.87 to 1.14) | 42 (1 RCT) | ⊕⊝⊝⊝ VERY LOW 1 2 5 | ||
| 952 per 1000 | 952 per 1000 (829 to 1000) | |||||
| Pain during laser treatment | Study population | RR 1.00 (0.36 to 2.76) |
62 (2 RCTs) |
⊕⊝⊝⊝ VERY LOW 1 6 | ||
| 190 per 1000 | 190 per 1000 (69 to 524) | |||||
| Vision‐related QoL ‐ not reported | ‐ | ‐ | ‐ | ‐ | ‐ | |
| Adverse events | Vitreous haemorrhage, 13% of argon group, RR 1.22 (0.38 to 3.94); choroidal detachment, 19% of argon group, RR 0.23 (0.04 to 1.27); neurotrophic keratopathy, 10% of argon group, RR 1.29 (0.35 to 4.75). | 62 (2 RCT) | ⊕⊝⊝⊝ VERY LOW 1 2 7 | |||
| *The risk in the intervention group (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 | ||||||
| GRADE Working Group grades of evidence High‐certainty: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate‐certainty: We are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low‐certainty: Our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low‐certainty: We have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
1 Downgraded for risk of bias (−1): high risk of performance and detection bias.
2 Downgraded for imprecision (−1): small study, wide confidence intervals
3Downgraded for indirectness (−1): outcome was loss 2 or more lines of Snellen at 6 months
4 Downgraded for indirectness (−1): outcome was not clearly defined — "PDR worsened" — and was reported at 29 months
5 Downgraded for indirectness (−1): outcome was not clearly defined — "PDR improved" — and was reported at 29 months
6 Downgraded for imprecision (−2): small study, few events
7 Downgraded for inconsistency (−1): there was some inconsistency between studies