Summary of findings for the main comparison. AMT during acute phase of moderate ocular burns.
| AMT during acute phase of moderate ocular burns | ||||||
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Patient or population: patients with moderate acute ocular burns
Settings: ophthalmic hospital
Intervention: AMT and medical therapy Control: medical therapy alone | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No. of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | AMT | |||||
| Epithelial defect on day 21 post‐injury Image analysis of digital photographs Follow‐up: 6 months to 24 months | 350 per 1000 | 63 per 1000 (7 to 458) | RR 0.18 (0.02 to 1.31) | 36 (1 study) | ⊕⊕⊝⊝ low1 | |
| Visual acuity at final follow‐up LogMAR. Scale from: 0 to 3 Follow‐up: 6 months to 24 months | The mean visual acuity at final follow‐up in the control groups was 0.38 | The mean visual acuity at final follow‐up in the intervention groups was 0.32 lower (0.09 to 0.55 lower) | 36 (1 study) | ⊕⊝⊝⊝ very low2,3,4 | ||
| *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% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI) AMT: amniotic membrane transplantation; CI: confidence interval; 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. | ||||||
1 Epithelial defect assessed on day of clinic review, not daily. Defect was assessed under partially opaque membrane. This suggests possible imputation of data. 2 High risk of performance and detection biases, as not possible to mask personnel and outcome assessors. 3 Baseline imbalance in visual acuities between treatment and control groups. Mean visual acuity in control eyes significantly worse than treatment eyes at presentation. Improvement in visual acuity was greater in control group. Follow‐up was significantly longer in treatment group. In a number of control eyes, outcome was very poor, suggesting possible misclassification. These factors could have skewed findings in favour of treatment. 4 Visual acuity measured at final follow‐up rather than at a fixed interval.