Ahmad 2002.

Methods	Study design: randomized controlled trial, parallel group Unit of analysis: eyes Number randomized: 44 total, 22 per group Number analyzed: 44 total, 22 per group Number of arms: 2 Enrollment start year: 1999 Length of follow‐up: more than 9 months Sample size calculations: not reported Losses to follow‐up: none
Participants	Country: India Age (mean (SD)): 45.4 (NR) in the MMC group; 44.9 (NR) in the EX‐DCR alone group Females (n (%)): not reported Inclusion criteria: diagnosis of primary acquired nasolacrimal duct obstruction Exclusion criteria: not reported Study group differences: not reported
Interventions	Intervention: EX‐DCR with application of 0.2 mg/mL MMC Comparison intervention: EX‐DCR alone
Outcomes	Measured outcomes: functional success, defined as the relief of epiphora, at 3 months and 9 months anatomic success, defined as patency to lacrimal irrigation, at 3 months and 9 months Adverse events: fibrous tissue growth, scarring or granulation tissue formation, delayed wound healing
Identification	Author name: Sheikh Sajjad Ahmad Institution: SKIMS Medical College Email: not reported
Notes	Funding source: not reported Declarations of interest: not reported Trial registration number: not reported
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Method of random sequence generation was not reported.
Allocation concealment (selection bias)	Unclear risk	Treatment allocation concealment was not reported.
Blinding of participants and personnel (performance bias) All outcomes	High risk	Although it seems participants were masked to treatment, the operating doctor knew the treatment group (using an applicator versus not using an applicator).
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Authors state that: "All the examinations were done by the same physician with double blind control", but it is unclear whether this means outcome assessors were masked.
Incomplete outcome data (attrition bias) All outcomes	Low risk	Attrition not reported, but participants were analyzed in the group to which they had been randomized.
Selective reporting (reporting bias)	Unclear risk	Trial not registered, and no protocol available for comparison to ascertain selective outcome reporting.
Other bias	Low risk	Study appears to be free of other sources of bias.