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

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.

Comparison of bilateral/unilateral lateral rectus recession and unilateral recession-resection for intermittent exotropia: a Meta-analysis.

AIM: To compare the effectiveness of unilateral recession-resection (R&R) and bilateral/unilateral recession (BLR/ULR) for treatment of basic type of intermittent exotropia [IX(T)]. METHODS: A comprehensive literature search was performed using PubMed, EMBASE, and the Cochrane Library, to identify randomized controlled trials and comparative studies regarding the effectiveness of R&R and BLR/ULR for IX(T). Based on which, a Meta-analysis was then performed in terms of long-term success rate, overcorrection rate, and recurrence rate. RESULTS: Nine studies in total satisfy the specified eligibility criteria. BLR is at disadvantage to R&R at a short-term follow-up [<2y, OR 0.56 (0.33-0.94) for success rate; OR 2.11 (1.17, 3.81) for undercorrection rate]. However, BLR achieved a higher success rate [OR 2.49 (1.61, 3.86)] and a lower undercorrection rate [OR 0.40 (0.23, 0.71)], compared to that of R&R at a long-term follow-up (>2y). There is no significant difference was found in overcorrection rate, regardless of the length of follow-up time [OR 0.85 (0.41, 1.75)]. In the treatment for small-angle IX(T), the final outcome was significantly different between the groups, demonstrating a more successful alignment [OR 0.37 (0.18, 0.74)] and a lower undercorrection [OR 3.50 (1.28, 7.26)] in the R&R group than in the ULR group. While for moderate-angle IX(T) (20 PD-25 PD), the effectiveness of R&R and ULR is quite equivalent with similar success rate [OR 1.08 (0.65, 1.79)] and undercorrection rate [OR 0.89 (0.54, 1.48)]. CONCLUSION: As regard to the effect of BLR and R&R, R&R shows an advantage over BLR at short term. But, BLR is more effective in the long term for the basic type IX(T) in children. R&R surgery should be a better choice for the treatment of small-angle IX(T) of ≤20 PD than ULR. However, both of ULR and R&R are recommended for moderate-angle IX(T) from 20 PD to 25 PD.