Cochrane · systematic review · CD001132
5‐Fluorouracil for glaucoma surgery
Green, E, Wilkins, M, Bunce, C, et al. · Cochrane Database of Systematic Reviews · 2014 · Cochrane Library
Eyes and VisionAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
36
current version
GRADE rated
29
No studies
7
Included studies
NR
No studies 7 · 19.4%Ungraded 0 · 0%Very low 5 · 13.9%Low 11 · 30.6%Moderate 9 · 25%High 4 · 11.1%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Regular‐dose postoperative 5‐Fluorouracil versus control for glaucoma surgery
Population: participants with glaucoma surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure at 12 months Regular‐dose postoperative 5‐Fluorouracil vs control | RR 0.39 [0.26, 0.58] | 6 studies · 469 participants | Low Downgraded: risk of bias |
Mean intraocular pressure at 12 months Regular‐dose postoperative 5‐Fluorouracil vs control | no estimate extracted | NR | No studies |
Complications ‐ wound leak Regular‐dose postoperative 5‐Fluorouracil vs control | RR 1.38 [0.93, 2.04] | 6 studies · 469 participants | Low Downgraded: risk of bias |
Complications ‐ hypotonous maculopathy Regular‐dose postoperative 5‐Fluorouracil vs control | no estimate extracted | NR | No studies |
Complications ‐ shallow anterior chamber Regular‐dose postoperative 5‐Fluorouracil vs control | RR 1.84 [0.76, 4.46] | 6 studies · 469 participants | Low Downgraded: risk of bias |
Complications ‐ epithelial toxicity Regular‐dose postoperative 5‐Fluorouracil vs control | RR 1.56 [1.36, 1.78] | 6 studies · 469 participants | Low Downgraded: risk of bias |
Regular‐dose postoperative 5‐Fluorouracil versus control for glaucoma surgery ‐ high risk of failure subgroup
Population: participants with glaucoma surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure at 12 months ‐ high risk of failure Regular‐dose postoperative 5‐Fluorouracil vs control | RR 0.44 [0.29, 0.68] | 2 studies · 239 participants | Moderate Downgraded: risk of bias |
Mean intraocular pressure at 12 months ‐ high risk of failure Regular‐dose postoperative 5‐Fluorouracil vs control | no estimate extracted | 1 study · 26 participants | Moderate Downgraded: risk of bias |
Complications ‐ wound leak ‐ high risk of failure Regular‐dose postoperative 5‐Fluorouracil vs control | RR 1.64 [1.04, 2.58] | 2 studies · 239 participants | Moderate Downgraded: risk of bias |
Complications ‐ hypotonous maculopathy ‐ high risk of failure ‐ not reported Regular‐dose postoperative 5‐Fluorouracil vs control | no estimate extracted | NR | No studies |
Complications ‐ shallow anterior chamber ‐ high risk of failure Regular‐dose postoperative 5‐Fluorouracil vs control | RR 2.41 [0.88, 6.58] | 2 studies · 239 participants | Moderate Downgraded: risk of bias |
Complications ‐ epithelial toxicity ‐ high risk of failure Regular‐dose postoperative 5‐Fluorouracil vs control | RR 1.25 [1.12, 1.38] | 2 studies · 239 participants | Moderate Downgraded: risk of bias |
Regular‐dose postoperative 5‐Fluorouracil versus control for glaucoma surgery ‐ combined surgery subgroup
Population: participants with glaucoma surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure at 12 months ‐ combined surgery Regular‐dose postoperative 5‐Fluorouracil vs control | no estimate extracted | 2 studies · 118 participants | Very low Downgraded: risk of bias |
Mean intraocular pressure at 12 months ‐ combined surgery Regular‐dose postoperative 5‐Fluorouracil vs control | no estimate extracted | 2 studies · 118 participants | Low Downgraded: risk of bias |
Complications ‐ wound leak ‐ combined surgery Regular‐dose postoperative 5‐Fluorouracil vs control | RR 0.9 [0.36, 2.23] | 2 studies · 118 participants | Low Downgraded: risk of bias |
Complications ‐ hypotonous maculopathy ‐ combined surgery ‐ not reported Regular‐dose postoperative 5‐Fluorouracil vs control | no estimate extracted | NR | No studies |
Complications ‐ shallow anterior chamber ‐ combined surgery Regular‐dose postoperative 5‐Fluorouracil vs control | no estimate extracted | 2 studies · 118 participants | Very low Downgraded: risk of bias |
Complications ‐ epithelial toxicity ‐ combined surgery Regular‐dose postoperative 5‐Fluorouracil vs control | RR 3.04 [1.56, 5.92] | 2 studies · 118 participants | Low Downgraded: risk of bias |
Regular‐dose postoperative 5‐Fluorouracil versus control for glaucoma surgery ‐ primary trabeculectomy subgroup
Population: participants with glaucoma surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure at 12 months ‐ primary trabeculectomy Regular‐dose postoperative 5‐Fluorouracil vs control | RR 0.21 [0.06, 0.68] | 2 studies · 112 participants | Moderate Downgraded: risk of bias |
Mean intraocular pressure at 12 months ‐ primary trabeculectomy Regular‐dose postoperative 5‐Fluorouracil vs control | no estimate extracted | 2 studies · 112 participants | Low Downgraded: risk of bias |
Complications ‐ wound leak ‐ primary trabeculectomy Regular‐dose postoperative 5‐Fluorouracil vs control | RR 0.47 [0.04, 4.91] | 2 studies · 112 participants | Low Downgraded: risk of bias |
Complications ‐ hypotonous maculopathy ‐ primary trabeculectomy Regular‐dose postoperative 5‐Fluorouracil vs control | no estimate extracted | 1 study · 62 participants | Moderate Downgraded: risk of bias |
Complications ‐ shallow anterior chamber ‐ primary trabeculectomy Regular‐dose postoperative 5‐Fluorouracil vs control | RR 0.47 [0.04, 4.91] | 2 studies · 112 participants | Low Downgraded: risk of bias |
Complications ‐ epithelial toxicity ‐ primary trabeculectomy Regular‐dose postoperative 5‐Fluorouracil vs control | RR 5.85 [2.04, 16.83] | 2 studies · 112 participants | Low Downgraded: risk of bias |
Low‐dose postoperative 5‐Fluorouracil versus control for glaucoma surgery
Population: participants with glaucoma surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure at 12 months Low‐dose postoperative 5‐Fluorouracil vs control | RR 0.93 [0.7, 1.24] | 1 study · 76 participants | Very low Downgraded: risk of bias |
Mean intraocular pressure at 12 months Low‐dose postoperative 5‐Fluorouracil vs control | no estimate extracted | 1 study · 76 participants | Very low Downgraded: risk of bias |
Complications ‐ wound leak Low‐dose postoperative 5‐Fluorouracil vs control | RR 0.33 [0.01, 7.93] | 1 study · 76 participants | Very low Downgraded: risk of bias |
Complications ‐ hypotonous maculopathy ‐ not reported Low‐dose postoperative 5‐Fluorouracil vs control | no estimate extracted | NR | No studies |
Complications ‐ shallow anterior chamber ‐ not reported Low‐dose postoperative 5‐Fluorouracil vs control | no estimate extracted | NR | No studies |
Complications ‐ epithelial toxicity ‐ not reported Low‐dose postoperative 5‐Fluorouracil vs control | no estimate extracted | NR | No studies |
Intraoperative 5‐Fluorouracil versus placebo or control for glaucoma surgery
Population: participants with glaucoma surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure at 12 months Need for repeat surgery or uncontrolled IOP (usually more than 22 mm Hg) despite additional topical or systemic medications Intraoperative 5‐Fluorouracil vs placebo or control | RR 0.68 [0.51, 0.92] | 4 studies · 711 participants | High |
Mean intraocular pressure at 12 months Intraoperative 5‐Fluorouracil vs placebo or control | no estimate extracted | 4 studies · 711 participants | High |
Complications ‐ wound leak Intraoperative 5‐Fluorouracil vs placebo or control | RR 1.36 [1, 1.84] | 4 studies · 711 participants | High |
Complications ‐ hypotonous maculopathy Intraoperative 5‐Fluorouracil vs placebo or control | RR 1.47 [0.42, 5.12] | 4 studies · 711 participants | Moderate |
Complications ‐ shallow anterior chamber Intraoperative 5‐Fluorouracil vs placebo or control | RR 1.99 [1.22, 3.22] | 4 studies · 711 participants | High |
Complications ‐ epithelial toxicity Intraoperative 5‐Fluorouracil vs placebo or control | RR 1.23 [0.85, 1.77] | 4 studies · 711 participants | Moderate |