Efficacy and Safety of the Intraoperative Application of Mitomycin in Glaucoma Patients with Trabeculectomy: A Systematic Review and Meta-Analysis

IF 2.1 4区 医学 Q3 PHARMACOLOGY & PHARMACY
Zhi-Hui Song, Shanshan Xu, Guang-Yao Li, Entang Wang, Yi-man Li, Chao Zhang
{"title":"Efficacy and Safety of the Intraoperative Application of Mitomycin in Glaucoma Patients with Trabeculectomy: A Systematic Review and Meta-Analysis","authors":"Zhi-Hui Song, Shanshan Xu, Guang-Yao Li, Entang Wang, Yi-man Li, Chao Zhang","doi":"10.1155/2023/5249552","DOIUrl":null,"url":null,"abstract":"What Is Known and Objective. The primary cause of trabeculectomy failure in glaucoma surgery is the imperfect formation of the filter bubble, which blocks the filtration effect. This systematic review and meta-analysis aimed to compare the effects and safety of mitomycin C (MMC) or no antimetabolite in trabeculectomies cases that require needling revision. Methods. We searched PubMed, Cochrane, and EMBASE to identify randomized trials published between the time the databases were built and May 31, 2022. To compare the effectiveness and safety of mitomycin with or without mitomycin in trabeculectomy, intraocular pressure (IOP), the surgical failure rate, and functional follicle formation were used as efficacy indicators, and the occurrence of postoperative complications was used as a safety indicator. Meta-analyses were performed for comparisons. Results and Discussion. After trabeculectomy, MMC was significantly better than a placebo at lowering postoperative IOP (MD = −11.31 mmHg, 95% CI −19.73 to −2.88 mmHg). MMC outperformed the control group in terms of filtering blebs formation (relative risk (RR) = 1.18, 95% CI: 1.09 to 1.27). The surgical failure rate was significantly lower with MMC compared to placebo (RR = 0.35, 95% CI: 0.22 to 0.58). No significant difference was observed between MMC and placebo in terms of hypotony, anterior chamber bleeding, filter bubble leakage, and endophthalmitis, apart from the shallow anterior chamber (RR: 1.51, 95% CI: 1.02 to 2.25). What Is New and Conclusion. The use of MMC in glaucoma trabeculectomy can increase the success rate of the procedure and provide significant patient benefits. However, it is important to be extremely careful and aware of complications such as shallow anterior chambers.","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2023-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Pharmacy and Therapeutics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1155/2023/5249552","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
引用次数: 0

Abstract

What Is Known and Objective. The primary cause of trabeculectomy failure in glaucoma surgery is the imperfect formation of the filter bubble, which blocks the filtration effect. This systematic review and meta-analysis aimed to compare the effects and safety of mitomycin C (MMC) or no antimetabolite in trabeculectomies cases that require needling revision. Methods. We searched PubMed, Cochrane, and EMBASE to identify randomized trials published between the time the databases were built and May 31, 2022. To compare the effectiveness and safety of mitomycin with or without mitomycin in trabeculectomy, intraocular pressure (IOP), the surgical failure rate, and functional follicle formation were used as efficacy indicators, and the occurrence of postoperative complications was used as a safety indicator. Meta-analyses were performed for comparisons. Results and Discussion. After trabeculectomy, MMC was significantly better than a placebo at lowering postoperative IOP (MD = −11.31 mmHg, 95% CI −19.73 to −2.88 mmHg). MMC outperformed the control group in terms of filtering blebs formation (relative risk (RR) = 1.18, 95% CI: 1.09 to 1.27). The surgical failure rate was significantly lower with MMC compared to placebo (RR = 0.35, 95% CI: 0.22 to 0.58). No significant difference was observed between MMC and placebo in terms of hypotony, anterior chamber bleeding, filter bubble leakage, and endophthalmitis, apart from the shallow anterior chamber (RR: 1.51, 95% CI: 1.02 to 2.25). What Is New and Conclusion. The use of MMC in glaucoma trabeculectomy can increase the success rate of the procedure and provide significant patient benefits. However, it is important to be extremely careful and aware of complications such as shallow anterior chambers.
青光眼小梁切除术患者术中应用丝裂霉素的疗效和安全性:一项系统综述和荟萃分析
什么是已知的和客观的。青光眼手术中小梁切除术失败的主要原因是过滤气泡的不完全形成,从而阻碍了过滤效果。这项系统综述和荟萃分析旨在比较丝裂霉素C(MMC)或不使用抗代谢药物治疗需要针刺矫正的小梁切除术病例的效果和安全性。方法。我们搜索了PubMed、Cochrane和EMBASE,以确定数据库建立至2022年5月31日之间发表的随机试验。为了比较小梁切除术中使用或不使用丝裂霉素的丝裂霉素的有效性和安全性,将眼压(IOP)、手术失败率和功能性卵泡形成作为疗效指标,并将术后并发症的发生率作为安全指标。进行荟萃分析进行比较。结果和讨论。小梁切除术后,MMC在降低术后眼压方面明显优于安慰剂(MD = −11.31 mmHg,95%CI−19.73至−2.88 mmHg)。MMC在滤过泡形成方面优于对照组(相对风险(RR) = 1.18,95%可信区间:1.09-1.27)。与安慰剂相比,MMC的手术失败率显著降低(RR = 0.35,95%CI:0.22至0.58)。除浅前房外,MMC和安慰剂在低眼压、前房出血、滤过泡渗漏和眼内炎方面没有观察到显著差异(RR:1.51,95%CI:1.02至2.25)。新情况和结论。MMC在青光眼小梁切除术中的应用可以提高手术的成功率,并为患者带来显著的益处。然而,重要的是要非常小心,并注意并发症,如浅前房。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
4.10
自引率
5.00%
发文量
226
审稿时长
6 months
期刊介绍: The Journal of Clinical Pharmacy and Therapeutics provides a forum for clinicians, pharmacists and pharmacologists to explore and report on issues of common interest. Reports and commentaries on current issues in medical and pharmaceutical practice are encouraged. Papers on evidence-based clinical practice and multidisciplinary collaborative work are particularly welcome. Regular sections in the journal include: editorials, commentaries, reviews (including systematic overviews and meta-analyses), original research and reports, and book reviews. Its scope embraces all aspects of clinical drug development and therapeutics, including: Rational therapeutics Evidence-based practice Safety, cost-effectiveness and clinical efficacy of drugs Drug interactions Clinical impact of drug formulations Pharmacogenetics Personalised, stratified and translational medicine Clinical pharmacokinetics.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信