Intra-operative mitomycin C for nonpenetrating filtering surgery in treatment of open angle glaucoma: A systematic review and meta-analysis / 第二军医大学学报

ABSTRACT

Objective To compare the efficacy and tolerability between nonpenetrating filtering surgery with (NPFS-MMC) and without (NPFS-noMMC) intraoperative mitomycin C application for treatment open angle glaucoma. Methods Pertinent studies were selected through extensive searches of the Cochrane Library, PubMed, Embase, and Chinese Biomedicine Database. Eight controlled clinical trials meeting the pre-defined criteria were systematically reviewed by meta-analysis. The main outcome measures were percentage intraocular pressure reduction (IOPR%), complete remission rate, total remission rate, and complications. The pooled estimates were carried out using RevMan version 5.0 software. Results The weighted mean differences of the IOPR% between the NPFS-MMC group and NPFS-noMMC group were 5.24% (95% confidence intervals\[95%CI\], -3.24 to 13.72) after 6 months, 8.31% (95%CI,4.33 to 12.30) after 12 months(P<0.05), 9.56% (95%CI, 4.88 to 14.24) after 24 months(P<0.05), and 14.45% (95%CI, 9.02 to 19.88) after 36 months(P<0.05). NPFS-MMC was associated with significant greater complete remission rates compared with NPFS-noMMC, with the pooled risk difference being 1.16 (95%CI, 1.05 to 1.27) after 6 months(P<0.05), 1.20 (95%CI, 1.05 to 1.38) after 12 months (P<0.05), 1.30 (95%CI, 1.05 to 1.61) after 24 months (P<0.05), and 1.36 (95%CI, 1.06 to 1.73) after 36 months (P<0.05). Intraoperative mitomycin C was not associated with any drug-induced complications. Conclusion The use of intraoperative mitomycin C is safe and can improve the effect of nonpenetrating filtering surgery in patients with open ganle glaucoma.