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Ologen implant versus mitomycin-C for trabeculectomy: A meta-analysis. | LitMetric

Ologen implant versus mitomycin-C for trabeculectomy: A meta-analysis.

Medicine (Baltimore)

Department of Ophthalmology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China.

Published: June 2019

AI Article Synopsis

  • The study aimed to assess the effectiveness and safety of trabeculectomy with mitomycin-C (MMC) compared to trabeculectomy with an implant.
  • A meta-analysis of 11 studies with 443 participants found that trabeculectomy with MMC led to greater reductions in intraocular pressure (IOP) at 1, 3, 6, and 12 months post-surgery, while showing a higher risk of certain complications like hypotony and suture lysis.
  • Ultimately, trabeculectomy with MMC was more effective in lowering IOP but came with a higher incidence of some adverse effects, although there was no significant difference in overall success rates or medication reduction.

Article Abstract

Aim: To evaluate the efficacy and safety of trabeculectomy (Trab) with mitomycin-C (MMC) versus Trab with implant.

Methods: Studies published in different languages were retrieved by systematically searching Embase, PubMed, Cochrane library, China Biology Medicine disc, and Google Scholar from 1966 to April 2018, as well as manually examining the references of the original articles. The outcome measures of efficacy covered intraocular pressure, glaucoma medications reductions, and success rate. Safety evaluation was measured by relative ratio of complications.

Results: A total of 11 studies involving 443 participants were covered in this meta-analysis. The weighted mean difference (WMD) in the percentage of intraocular pressure (IOP) reduction (IOPR%) comparing Ologen group with MMC group was -3.69 (95% CI: -6.70 to -0.68) at 1 month, -2.69 (-5.17 to -0.21) at 3 months, -3.67 (-6.09 to -1.25)at 6 months, -3.24 (-6.08 to -0.41) at 12 months, 1.24 (-9.43 to 11.90) at 24 months, and 1.10 (-10.11 to 12.31) at 60 months, which showed that there was statistically significant difference at 1,3, 6, and12 months after the surgery. A significantly higher incidence of postsurgery hypotony (0.64 (95% Cl: 0.42 to 0.98)) and suture lysis (0.30 (95% CI: 0.10-0.93)) was observed in MMC group. However, there was no significant difference in the reduction in glaucoma medications, success rate, and incidence of other complications.Trab with 0.2 mg/mL MMC presented higher rates of complete success compared with Trab with 0.4 mg/mL MMC (P = .01).

Conclusion: Trab with MMC was associated with a higher IOP-lowering efficacy and a higher incidence of postsurgery hypotony and suture lysis in contrast to that of Trab with Ologen.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6636945PMC
http://dx.doi.org/10.1097/MD.0000000000016094DOI Listing

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