Summary of findings 3. Intracameral mydriatics compared to depot delivery systems for mydriasis in cataract surgery.
| Intracameral mydriatics compared to depot delivery systems for mydriasis in cataract surgery | |||||
| Patient or population: patients undergoing cataract surgery Setting: hospital Intervention: intracameral mydriatics Comparison: depot delivery systems | |||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | |
| Risk with depot delivery systems | Risk with intracameral mydriatics | ||||
| Mean pupillary diameter—at the time the surgeon performs capsulorhexis (mm) | ‐ | ‐ | ‐ | ‐ | Data were not reported. |
| Mean pupillary diameter—at the beginning of cataract surgery (mm) | The mean pupillary diameter at the beginning of cataract surgery was 0. | MD 1.9 lower (2.45 lower to 1.35 lower) | ‐ | 60 (1 RCT) | ⊕⊕⊝⊝ VERY LOW 1 2 |
| Mean pupillary diameter—at the end of cataract surgery (mm) | The mean pupillary diameter at the end of cataract surgery was 8.2. | MD 1.6 lower (2.13 lower to 1.07 lower) | ‐ | 60 (1 RCT) | ⊕⊕⊝⊝ VERY LOW 1 2 |
| Intraoperative surgical time—total intraoperative time (min) | The mean intraoperative surgical time—total intraoperative time was 7.7. | The mean difference in intraoperative surgical times reportedly favored depot delivery (MD 4.2 min, P < 0.05, ANOVA) | ‐ | 60 (1 RCT) |
⊕⊕⊝⊝ VERY LOW 1 2 |
| AE: participant‐reported ocular discomfort—week 1 | ‐ | ‐ | ‐ | ‐ | Data were not reported. |
| AE: participant‐reported ocular discomfort—month 1 | ‐ | ‐ | ‐ | ‐ | Data were not reported. |
| Adverse events | Posterior capsule rupture occurred at the irrigation/aspiration phase in 1 participant (3.3%), and iris‐related complications, including flaccid iris, iris herniation, and iris capture by the handpiece, were observed in 11 participants (36.6%), all in the intracameral mydriatics group. No complication was reported for the depot delivery system group. | ‐ | 60 (1 RCT) |
⊕⊕⊝⊝ VERY LOW 1 2 |
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| *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). AE: adverse event; ANOVA: analysis of variance; CI: confidence interval; MD: mean difference; RCT: randomized controlled trial | |||||
| 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. | |||||
1Downgraded one level for risk of bias (most 'Risk of bias' domains were either unclear or high risk). 2Downgraded two levels for imprecision due to small sample size and wide confidence intervals.