||Uncertainties identified in research recommendations
||Cochrane Eyes and Vision Group
|Why is there uncertainty?
||Reliable up-to-date systematic reviews have revealed important continuing uncertainties about treatment effects
Implications for Research Low-quality evidence warrants better quality trials to determine the comparative effectiveness of all devices included in this review. These studies are limited and the applicability of the evidence to other population or settings remains unclear. More research is therefore needed to generate evidence for or against devices such as Ex-PRESS, Ologen, amniotic membrane, Gelfilm, E-PTFE, gold micro shunt, and T-flux. In the absence of definitive evidence, we need more trials of better quality for most comparisons and outcomes. These should account for losses to follow-up at each follow-up time point measured. They should also account for the correlation of outcomes between two eyes when applicable. They also need to consider the appropriate use of adjunctive agents, such as mitomycin C in both groups to ensure comparability. It would be helpful for future trials to specify the types of glaucomas, and also to consider stratifying participants by type of glaucoma, and perhaps by lens type, when the sample size is met. We need further research to evaluate the effectiveness and safety of each intervention on patients with different types of glaucoma. Data reporting needs to improve to include reporting of differences between groups to allow more robust inferences when applicable. Future trials should also report on the elements of trial quality identified above and ensure consistency between protocols and published studies.
References to reliable up-to-date systematic reviews:
Wang X, Khan R, Coleman A. Device-modified trabeculectomy for glaucoma. Cochrane Database of Systematic Reviews 2015, Issue 12. Art. No.: CD010472. DOI: 10.1002/14651858.CD010472.pub2
|What is needed?
|Systematic reviews that need updating or extending
|Systematic reviews in preparation
|Ongoing controlled trials
||Ologen (OculusGen)-Glaucoma MMC control trial in India
Oculusgen (Ologen) Glaucoma MMC control in Estonia
Comparative study of the safety and effectiveness of Ologen Collagen Matrix versus mitomycin-C in glaucoma filtering surgery
|Which health conditions?
||Eyes and vision | Glaucoma
|What is person's age?
|Which types of treatments?
||Devices | Surgery
Change in glaucoma symptoms, or change in management of symptoms (change in vision, blindness, change in intraocular pressure (IOP) at one year, incidence of hypotony ); adverse effects or complications; patient satisfaction; health related quality of life; service related issues; and health related cost
||Publication date:10 Mar 2016
|Last reviewed date:10 Mar 2017
||Publication Type:Known Uncertainty
|The DUETs team endeavours to ensure that information is correct at the time of data entry