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Marcelo J. Silva, Ligia I. Fendi, Gustavo V. Arruda, Jayter S. Paula; A Meta-analysis of Randomized Clinical Trials comparing Mitomycin C versus 5-Fluorouracil as an Adjunctive Treatment for Trabeculectomy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2525.
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Mitomycin C (MMC) and 5-fluouracil (5-FU) are the most frequently utilized adjuvant therapies in trabeculectomy (TRAB), but no concordant recommendation is established regarding the choice of which would be the best treatment. The aim of this study was to compare directly the efficacy and safety of augmenting TRAB with MMC or 5-FU.
Pertinent studies were selected through systematic searches of major literature databases. Clinical controlled trials comparing 5-FU with MMC in trabeculectomy were selected. For categorical variables, weighted means, risk ratios or odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using Rev Man software, version 5.0, provided by the Cochrane Collaboration. The results were tested for heterogeneity at a significance level of P < 0.05.
A meta-analysis of five of these RCTs showed a lower pooled intraocular pressure (IOP) at 12 months in the MMC arm than in the 5-FU arm (mean difference = -2.17 mmHg; 95% CI: -3.26, -1.08; P0.2mg/ml) were significantly more effective in improving qualified success. Epithelial corneal defects were significantly related to 5-FU treatment (P=0.02). There were no significant differences in other related complications.
Treatment protocols of augmenting TRAB with MMC appeared to improve surgical success rates when compared to those of 5-FU and is not significantly associated with increased incidences of postoperative complications.
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