Table 3.

Summary of outcome success in Ex-DCR and En-DCR

Mitomycin-C as adjuvant therapy in dacryocystorhinostomy for the treatment of nasolacrimal duct obstruction
Patient: people with lacrimal obstruction Setting: hospital Intervention: DCR with MMC Comparation: DCR without MMC

Outcome	Illustrative comparative risks* (95% CI)		Relative effect (95% CI)	Number of participants (studies)	Quality of the evidence (GRADE)
	Assumed risk	Corresponding risk
	Without MMC	With MMC
Success follow-up from 3 to 36 months after DCR	803 per 1000	896 per 1000 (861 to 923)	OR 2.1 (1.52 to 2.9)	2158 (27)	⊕  ⊕  ⊕  ⊝  Moderatea
Success—Ex-DRC Follow-up from 3 to 36 months after DCR	827 per 1000	929 per 1000 (880 to 959)	OR 2.74 (1.54 to 4.87)	1099 (14)	⊕  ⊕  ⊕  ⊝  Moderatea
Success—En-DRC Follow-up from 3 to 36 months after DCR	779 per 1000	856 per 1000 (810 to 893)	OR 1.69 (1.21 to 2.37)	1059 (13)	⊕  ⊕  ⊕  ⊝  Moderatea

GRADE Working Group grades of evidence. High quality: Further research is very unlikely to change our confidence in the estimate of the effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of the 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 the effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate

*The basis for the assumed risk (e.g., the median control group risk across studies) is provided in the footnotes. 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; OR: odds ratio; MMC: mitomycin-C

^aDowngraded evidence due to the risk of bias in concealing the allocation of patients and blinding of participants, staff, and outcome assessors