Evidence map›Paper›PMID 31678934›Full record

SynthesisBMJ open2019

Difluprednate versus Prednisolone Acetate after Cataract Surgery: a Systematic Review and Meta-Analysis.

Mahmoud Tawfik KhalafAllah, Ahmed Basiony, Ahmed Salama

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.9field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 12 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

Mahmoud Tawfik KhalafAllahOphthalmology Department, Menoufia University Faculty of Medicine, Shebin El-Kom, Menoufia, Egypt mahmoud.tawfik@med.menofia.edu.eg.ORCID 0000-0001-7973-5883
Ahmed BasionyOphthalmology Department, Menoufia University Faculty of Medicine, Shebin El-Kom, Menoufia, Egypt.
Ahmed SalamaOphthalmology Department, Menoufia University Faculty of Medicine, Shebin El-Kom, Menoufia, Egypt.
Menoufia University · EG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTopical steroids are the cornerstone in controlling the inflammation after cataract surgery. Prednisolone acetate and difluprednate are the two main products for this purpose. However, it is unclear which one should be used in terms of effectiveness and safety.

designSystematic review and meta-analysis. DATA SOURCES: Medline via PubMed, Cochrane Central Register of Controlled Trials, Web of science and clinicaltrials.gov were searched through 10 January 2018, and updated on 20 July 2019, in addition to researching the references' lists of the relevant articles. ELIGIBILITY CRITERIA: Randomised-controlled trials (RCTs) comparing difluprednate and prednisolone acetate regardless of the dosing regimen used. DATA EXTRACTION AND SYNTHESIS: Two independent authors assessed the included RCTs regarding the risk of bias using the Cochrane tool. Relevant data were extracted, and meta-analysis was conducted using a random-effects model. The Grading of Recommendations Assessment, Development, and Evaluation approach was used to appraise the evidence quality.

resultsWe included six RCTs with 883 patients: 441 received difluprednate and 442 received prednisolone acetate. The evidence quality was graded as moderate for corneal oedema and intraocular pressure and low for anterior chamber (AC) clearance. After small incision cataract surgery, difluprednate was superior in clearing AC cells at 1 week (OR=2.5, p>0.00001) and at 2 weeks (OR=2.5, p=0.04), as well as clearing the AC flare at 2 weeks (OR=6.7, p=0.04). After phacoemulsification, difluprednate was superior in terms of corneal clarity at 1 day (OR=2.6, p=0.02) and 1 week after surgery (OR=1.96, p=0.0007). No statistically significant difference was detected between both agents at 1 month in effectiveness. Also, both agents were safe, evaluated by the ocular hypertension (OR=1.23, p=0.8).

conclusionWith low-to-moderate certainty, difluprednate and prednisolone acetate are safe agents for controlling the inflammation after cataract surgery. Difluprednate showed significant superiority in terms of AC cells and AC flare at 2 weeks postoperatively.

Indexed as

Cataract ExtractionAnimalsAnti-Inflammatory AgentsFluprednisoloneHumansPostoperative CarePostoperative ComplicationsPrednisoloneAnti-Inflammatory AgentsdifluprednateFluprednisolonePrednisoloneprednisolone acetatecataract and refractive surgerycataract surgerycorneal and external diseasesdifluprednatemedical ophthalmologypostoperative inflammationprednisolone acetate

Identifiers

PMID31678934
PMCPMC6830689
OpenAlexW2983877529

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.