| Objective:（1）Using meta analysis to compare and analyze the safety and efficacy of mitomycin C（MMC）and 5-fluorouracil（5-Fu）in glaucoma surgery.（2）To explore the safety and efficacy of MMC combined with compound trabeculectomy in clinical.Methods:（1）Case-control trial data of MMC and 5-Fu in glaucoma surgery in the databases of CNKI,VIP,Wan Fang,Pubmed,Embase and the Cochrane Library from the establishment of the database to March 2021 were collected,RevMan5.3 and Stata15.0 softwares were applied for statistical analysis.（2）A total of 38 eyes of 37 patients with glaucoma were collected from the First Affiliated Hospital of Dali University from June 2019 to December 2019.According to the combination of medication,they were divided into A group（20 cases,21 eyes）and B group（17 cases,17 eyes）.In the A group,used MMC combined with compound trabeculectomy.In the B group,only composite trabeculectomy was performed.The preoperative and postoperative clinical indicators of 2 groups were recorded and analyzed.Results:（1）A total of 10 literatures involving 631 eyes met the inclusion criteria to the meta analysis,the MMC group 313 eyes and 5-Fu group 318 eyes were included,and 4 of 8 indicators have statistical significance.The results of meta-analysis suggested that on the postoperative IOP,MMC has higher rate than 5-Fu[SMD=-0.40,95%CI（-0.74,-0.06）,P=0.02].On the part of the success rate,5-Fu was higher than MMC[OR=0.47.95%CI（0.30,0.75）,P=0.001],but assisted-drugs is still need.On the type of Ⅰ filtering bleb（functional type）,MMC has higher rate than 5-Fu[OR=4.53,95%CI（2.53,8.08）,P<0.00001].On the type of Ⅲ、Ⅳ filtering bleb（nonfunctional type）,5-Fu has higher rate than MMC[OR=0.29,95%CI（0.17,0.51）,P<0.0001].There were no significant differences on the complete success rate,the failure rate,Ⅱ filtering bleb,and the postoperative complications.（2）There were no significant differences in IOP of 2 groups preoperatively（P>0.05）.The IOP of 2 groups 1 week after opration were decreased（P<0.05）,but there were no significant differences of 2 groups in IOP after opration（P>0.05）.The A group had higher functional filtering bleb than the B group and had lower nonfunctional filtering bleb than the B group（P<0.05）.In complications,the A group had higher corneal endothelial injury than the B group and lower shallow anterior chamber than the B group（P<0.05）,there were no significant difference of other complications between the 2 groups（P>0.05）.Conclusion:（1）Both MMC and 5-Fu are most commonly drugs in anti-scarring.MMC is superior to 5-Fu in IOP and functional filtering bleb（Type Ⅰ）,and had lower nonfunctional filtering bleb（Type Ⅲ、Ⅳ）than 5-Fu after operation.Although 5-Fu had high part of success rate,it still needs drug-assisted treatment after surgery,so MMC may be in a better choice.（2）MMC combined with compound trabeculectomy can effectively reduce IOP,promoted the establishment of functional filter bleb,improve filtration function and reduce the incidence of shallow anterior chamber,but attention should be paid to the risk of postoperative complication.Considering of the quality of the included data in studys,therefore,the conclusion still needs to be supported by more rigorous and perfect clinical data. |
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