Summary of findings for the main comparison. MMC compared to 5‐FU for wound healing in glaucoma surgery.
| MMC compared to 5‐FU for wound healing in glaucoma surgery | ||||||
| Patient or population: wound healing in glaucoma surgery Settings: Intervention: MMC Comparison: 5‐FU | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants/eyes (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| 5‐FU | MMC | |||||
| Failure of functioning trabeculectomy at 1 year | Study population | Low‐risk population RR 0.65 (95% CI 0.19 to 2.20) High‐risk population RR 0.49 (95% CI 0.22 to 1.08) |
634 (11 RCTs: 6 including low‐risk population and 5 including high‐risk population) | ⊕⊕⊝⊝ LOW 1,2 | ||
| Low‐risk population: 74 per 1000 High‐risk population: 272 per 1000 |
Low‐risk population: 50 per 1000 High‐risk population: 137 per 1000 |
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| Intraocular pressure at 1 year | The mean intraocular pressure at 1 year ranged across 5‐FU groups. Low‐risk population: 10.9 to 14.3 mmHg High‐risk population: 14.8 to 16.3 mmHg |
The mean intraocular pressure at 1 year in the MMC groups had a range of values. Low‐risk population: 9.9 to 11.6 mmHg High‐risk population: 8.6 to 13.7 mmHg |
‐ | 386 (7 RCTs: 3 including low‐risk population and 4 including high‐risk population) | ⊕⊕⊝⊝ LOW 1,3 | |
| Loss of 2 or more lines of Snellen visual acuity at 1 year | Study population | Low‐risk population RR 2.00 (95% CI 0.53 to 7.59) High‐risk population RR 0.81 (95% CI 0.36 to 1.80) |
328 (5 RCTs: 2 including low‐risk population and 3 including high‐risk population) | ⊕⊕⊝⊝ LOW 2,4 | ||
| Low‐risk population: 47 per 1000 High‐risk population: 115 per 1000 |
Low‐risk population: 94 per 1000 High‐risk population: 96 per 1000 |
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| Postoperative complications: late hypotony | Study population | RR 1.37 (95% CI 0.41 to 4.63) | 211 (4 RCTs) | ⊕⊕⊝⊝ LOW 2,4 | ||
| 37 per 1000 | 59 per 1000 | |||||
| Postoperative complications: choroidal detachment | Study population | RR 0.86 (95% CI 0.45 to 1.63) | 494 (8 RCTs) | ⊕⊕⊝⊝ LOW 1,2 | ||
| 68 per 1000 | 70 per 1000 | |||||
| Postoperative complications: endophthalmitis | Study population | RR 3.89 (95% CI 0.44 to 34.57) | 315 (4 RCTs) | ⊕⊕⊝⊝ LOW 1,2 | ||
| 0 per 1000 | 19 per 1000 | |||||
| Quality of life at 1 year | Not reported | |||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in 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). 5‐FU: 5‐Fluorouracil; CI: confidence interval; MMC: mitomycin C; RCT: randomised controlled trial; RR: risk ratio | ||||||
| GRADE Working Group grades of evidence 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. | ||||||
1Downgraded for risk of bias: only one study at low risk of bias in all domains
2Downgraded for imprecision: wide confidence intervals
3Downgraded for inconsistency: I2 = 60%
4Downgraded for risk of bias: no study at low risk of bias in all domains