Abstract | OBJECTIVE: DESIGN: Systematic review and meta-analysis. PARTICIPANTS: Eight clinical trials, including 4 cohort and 4 randomized, enrolled 459 eyes. METHODS: Pertinent studies were selected through extensive searches of the Cochrane Library, MEDLINE, EMBASE, and meeting abstracts. Efficacy measures were weighted mean differences (WMDs) for the percentage intraocular pressure (IOP) reduction and relative risks (RRs) for success rates. Tolerability measures were RRs for adverse events. Pooled estimates were carried out in RevMan software v. 4.2. RESULTS:
NPGS augmented with MMC was associated with a numerically smaller but nonsignificant percentage reduction in IOP compared with TE plus MMC, with a WMD of -1.27% (95% CI -5.61 to 3.07) at 1 year, -4.55% (-10.35 to 1.24) at 2 years, -0.82% (-8.80 to 7.17) at 3 years, and -6.16% (-25.97 to 13.65) at 4 years. Significantly greater proportions of TE plus MMC patients than NPGS augmented with MMC patients achieved the target IOP without antiglaucoma medication at the end point, with a pooled RR of 0.74 (0.63-0.86). NPGS augmented with MMC was associated with a significantly lower frequency of shallow anterior chamber and cataract than TE plus MMC, with pooled RRs of 0.31 (0.16-0.60) and 0.23 (0.11-0.47), respectively. CONCLUSIONS:
NPGS augmented with MMC was associated with IOP-lowering efficacy comparable to that of TE plus MMC. However, significantly fewer patients achieved the target IOP with NPGS augmented with MMC than with TE plus MMC. NPGS augmented with MMC was better tolerated than TE plus MMC.
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Authors | Jin-Wei Cheng, Gui-Lin Xi, Rui-Li Wei, Ji-Ping Cai, You Li |
Journal | Canadian journal of ophthalmology. Journal canadien d'ophtalmologie
(Can J Ophthalmol)
Vol. 44
Issue 1
Pg. 76-82
(Feb 2009)
ISSN: 0008-4182 [Print] England |
PMID | 19169318
(Publication Type: Comparative Study, Journal Article, Meta-Analysis, Systematic Review)
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Chemical References |
- Alkylating Agents
- Mitomycin
|
Topics |
- Alkylating Agents
(administration & dosage)
- Clinical Trials as Topic
- Combined Modality Therapy
- Databases, Factual
- Filtering Surgery
(methods)
- Glaucoma, Open-Angle
(drug therapy, physiopathology, surgery)
- Humans
- Intraocular Pressure
(physiology)
- Mitomycin
(administration & dosage)
- Postoperative Complications
- Treatment Outcome
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