@article {935661,
	title = {Fornix-Based Versus Limbal-Based Conjunctival Trabeculectomy Flaps for Glaucoma: Findings From a Cochrane Systematic Review},
	journal = {Am J Ophthalmol},
	volume = {174},
	year = {2017},
	month = {2017 Feb},
	pages = {33-41},
	abstract = {PURPOSE: To compare effectiveness of fornix- and limbal-based conjunctival flaps in trabeculectomy surgery. DESIGN: Systematic review. METHODS: Setting: CENTRAL, MEDLINE, LILACS, ISRCTN registry, ClinicalTrials.gov, WHO, and ICTRP were searched to identify eligible randomized controlled trials (RCTs). STUDY POPULATION: RCTs in which benefits and complications of fornix- vs limbal-based trabeculectomy for glaucoma were compared in adult glaucoma patients. OBSERVATION PROCEDURE: We followed Cochrane methodology for data extraction. MAIN OUTCOME MEASURES: Proportion of failed trabeculectomies at 24\&nbsp;months, defined as the need for repeat surgery or uncontrolled intraocular pressure (IOP) \&gt;22\&nbsp;mm Hg, despite topical/systemic medications. RESULTS: The review included 6 trials with a total of 361 participants, showing no difference in effectiveness between fornix-based vs limbal-based trabeculectomy surgery, although with a high level of uncertainty owing to low event rates. In the fornix-based and limbal-based surgery, mean IOP at 12\&nbsp;months was similar, with ranges of 12.5-15.5\&nbsp;mm Hg and 11.7-15.1\&nbsp;mm Hg, respectively. Mean difference was 0.44\&nbsp;mm Hg (95\% CI\&nbsp;-0.45 to 1.33) and 0.86\&nbsp;mm Hg (95\% CI\&nbsp;-0.52 to 2.24) at 12 and 24\&nbsp;months of follow-up, respectively. Mean number of postoperative glaucoma medications was similar between the 2 groups. Mean difference was 0.02 (95\% CI\&nbsp;-0.15 to 0.19) at 12\&nbsp;months. As far as postoperative complications, an increased risk of shallow anterior chamber was observed in the limbal-based group. CONCLUSION: Similar efficacy of trabeculectomy surgery with respect to bleb failure or IOP control was observed in both types of conjunctival flap incisions. A significant difference was detected in the risk of postoperative shallow anterior chamber, which was increased in the limbal-based group.},
	issn = {1879-1891},
	doi = {10.1016/j.ajo.2016.10.006},
	author = {Al-Haddad, Christiane E and Abdulaal, Marwan and Al-Moujahed, Ahmad and Ervin, Ann-Margret and Ismail, Karine}
}
