Using medications (antimetabolites) to avoid scarring after cataract surgery, which might cause failure of a previous glaucoma operation

Review question: We reviewed the evidence on the effect of using medications (antimetabolites) to avoid scarring after cataract surgery, which might cause failure of a previous glaucoma operation. We did not find any trials to include in this review.

Background: Patients with glaucoma who have had an operation to improve the pressure in their eyes often need a further operation to remove cataracts. Antimetabolites to prevent scarring can be used during the cataract operation with the intention of preventing failure of the previous glaucoma operation.

Search date: The evidence is current to 10 June 2014.

Key results: We did not find any trials to include in this review.

Authors' conclusions: 

There are no RCTs of antimetabolites with cataract surgery in people with a functioning trabeculectomy. Appropriately powered RCTs are needed of antimetabolites during cataract surgery in patients with a functioning trabeculectomy.

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Background: 

Patients having cataract surgery have often earlier undergone a trabeculectomy for glaucoma. However, cataract surgery may be associated with failure of the previous glaucoma surgery and antimetabolites may be used with cataract surgery to prevent such failure. There is no systematic review on whether antimetabolites with cataract surgery prevent failure of a previous trabeculectomy.

Objectives: 

To assess the effects of antimetabolites with cataract surgery on functioning of a previous trabeculectomy.

Search strategy: 

We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2014, Issue 5), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to June 2014), EMBASE (January 1980 to June 2014), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to June 2014), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 10 June 2014. We also searched the Science Citation Index database (July 2013) and reference lists of potentially relevant studies.

Selection criteria: 

Randomised controlled trials (RCTs) of antimetabolites with cataract surgery in people with a functioning trabeculectomy.

Data collection and analysis: 

Two review authors independently reviewed the titles and abstracts from the electronic searches. Two review authors independently assessed relevant full-text articles and entered data.

Main results: 

We identified no RCTs to test the effectiveness of antimetabolites with cataract surgery in individuals with the intention of preventing failure of a previous trabeculectomy.

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