Intraoperative mitomycin C for nonpenetrating glaucoma surgery: a systematic review and meta-analysis.
OBJECTIVE
To evaluate the efficacy and tolerability between nonpenetrating glaucoma surgery with (NPGS-MMC) and without (NPGS-noMMC) intraoperative mitomycin C application in the treatment of patients with 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 predefined criteria were systematically reviewed by meta-analysis. The main outcome measures were percentage intraocular pressure reduction and complete success rate. The pooled estimates were carried out in RevMan version 5.0 software.


RESULTS
The weighted mean differences of the percentage intraocular pressure reduction when comparing NPGS-MMC with NPGS-noMMC were 5.24% (95% confidence intervals: -3.24-13.72) at 6 months, 8.31% (4.33 to 12.30) at 12 months, 9.56% (4.88 to 14.24) at 24 months, and 14.45% (9.03 to 19.88) at 36 months. NPGS-MMC was associated with significant greater complete success rates compared with NPGS-noMMC, with a pooled risk ratio being 1.16 (1.05 to 1.27) at 6 months, 1.20 (1.05 to 1.38) at 12 months, 1.30 (1.05 to 1.61) at 24 months, and 1.36 (1.06 to 1.73) at 36 months. Intraoperative MMC was not associated with any drug-induced complications.


CONCLUSIONS
The use of intraoperative MMC is a safe and effective additional step during nonpenetrating filtering surgery.
Cheng
Jin-Wei
JW
Department of Ophthalmology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.
Cai
Ji-Ping
JP
Li
You
Y
Wei
Rui-Li
RL
D000477:Alkylating Agents / Q000008:administration & dosage*; D002986:Clinical Trials as Topic; D016208:Databases, Factual; D018463:Filtering Surgery; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D007430:Intraoperative Care; D016685:Mitomycin / Q000008:administration & dosage*; D016896:Treatment Outcome
D000477:Alkylating Agents; D016685:Mitomycin