Evidence Table 6.  What is the effect of glaucoma surgery on the development and progression of cataract?

							Outcomes/Benefits

Study design: Randomized controlled trials

Advanced Glaucoma Intervention Study, The (AGIS):, 1998

United States

Followup: ≥24 months

Quality: 70%	1	240	NR	0	Trabeculoplasty	None Given	NR	NR	NR	54

	2	211	NR	0	Trabeculectomy	None Given	NR	NR	NR	73

	3	158	NR	0	Trabeculoplasty	None Given	NR	NR	NR	47

	4	167	NR	0	Trabeculectomy	None Given	NR	NR	NR	62

Blondeau, Phelps, 1981  United States 

Followup: ≥24 months

Quality: 75%	1	48	NR	0	Trabeculectomy	None Given	NR	NR	NR	0

	2	50	NR	0	Thermosclerostomy	None Given	NR	NR	NR	10

Collaborative Normal- Tension Glaucoma Study Group, 1998a

United States

Followup: ≥24 months

Quality: 67%	1	61	0.08	0	Trabeculoplasty

Trabeculectomy

Cataract extraction

Other medications	MMC

Intraoperative 5-FU

Postoperative 5-FU	23	NR	NR	NR

	2	79	0.03	0	Cataract extraction	None Given	11	NR	NR	NR

Collaborative Normal- Tension Glaucoma Study Group, 1998b

United States

Followup: ≥24 months

Quality: 67%	1	66	NR	0	Trabeculoplasty

Trabeculectomy

Cataract extraction

Antifibrosis agents

Other medications	MMC

Intraoperative 5-FU Postoperative 5-FU	NR	23	NR	NR

	2	79	NR	0	Cataract extraction	None Given	NR	11	NR	NR

Demailly, Kretz, 1992  Europe 

Followup: 6 to 11 months

Quality: 35%

	1	14	NR	NR	Trabeculectomy

Antifibrosis agents	Postoperative 5-FU	3	NR	NR	NR

	2	13	NR	NR	Trabeculectomy

Antifibrosis agents	None Given	3	NR	NR	NR

Kitazawa, Suemori- Matsushita, Yamamoto 

et al., 1993

Japan 

Followup: 6 to 11 months

Quality: 73%

	1	11	NR	0	Trabeculectomy

Antifibrosis agents	MMC	2	2	NR	NR

	2	11	NR	0	Trabeculectomy

Antifibrosis agents	MMC	0	0	NR	NR

Lewis, Phelps, 1984  

United States 

Followup: ≥24 months

Quality: 76%

	1	37	NR	0	Trabeculectomy	None Given	NR	NR	NR	3

	2	34	NR	0	Thermosclerostomy	None Given	NR	NR	NR	9

Robin, Ramakrishnan, Krishnadas et al., 1997  

India 

Followup: Not Reported

Quality: 78%	1	71	NR	0	Trabeculectomy	None Given	NR	0	18	0

	2	78	NR	0	Trabeculectomy

Antifibrosis agents	MMC	NR	3	24	3

	3	77	NR	0	Trabeculectomy

Antifibrosis agents	MMC	NR	1	32	1

	4	74	NR	0	Trabeculectomy

Antifibrosis agents	MMC	NR	2	23	2

Sanders, Cantor, Dobler 

et al., 1999  

United States 

Followup: 6 to 11 months

Quality: 88%	1	25	0.16	NR	Trabeculectomy

Antifibrosis agents	MMC	NR	NR	4	0

	2	25	0.08	NR	Trabeculectomy

Antifibrosis agents	MMC	NR	NR	3	1

Spaeth, 1980 

United States 

Followup: ≥24 months

Quality: 22%	1	15	NR	NR	Trabeculectomy	None Given	NR	NR	8	2

	2	15	NR	NR	Thermal sclerostomy	None Given	NR	NR	6	1

Wilson, 1989

St. Lucia

Followup: ≥24 months

Quality: 74%

	1	45	1.0	NR	Posterior sclerectomy	None Given	14	NR	NR	NR

	2	35	1.0	NR	Trabeculectomy	None Given	11	NR	NR	NR

Study design: Non-randomized controlled trials

Dastur, 1994

Bombay, India

Followup: ≥24 months

Quality: 44%	1	70	NR	0	Trabeculectomy	None Given	NR	NR	NR	12

	2	70	NR	0	Other medications	None Given	NR	NR	NR	0

Tuulonen, Niva, Alanko, 1987 

Europe

Followup: ≥24 months

Quality: 56%	1	32	NR	0	Trabeculoplasty	None Given	NR	NR	NR	3

	2	32	NR	0	Other medication	None Given	NR	NR	NR	3

Study design: Case-control studies

Costa, Smith, Spaeth et al., 1993

United States

Followup: 3 to 5 months

Quality: Not Applicable	1	16	0.12	NR	Trabeculectomy

Antifibrosis agents	MMC

Intraoperative 5-FU Postoperative 5-FU	5	NR	16	5

	2	68	0.12	NR	Trabeculectomy

Antifibrosis agents	MMC

Intraoperative 5-FU Postoperative 5-FU	0	NR	0	0

Study design: Clinical series

Asamoto, Yablonski, 1993

United States

Followup: ≥24 months

Quality: Not Applicable

	1	98	0.15	NR	Trabeculectomy

Air	None Given	NR	NR	47	20

	2	47	0.23	NR	Trabeculectomy

BSS	None Given	NR	NR	26	14

	3	12	0.08	NR	Trabeculectomy

Healon	None Given	NR	NR	6	2

	4	16	0.25	NR	Trabeculectomy	None Given	NR	NR	5	1

Cheung, Wright, Murali 

et al., 1997

United States

Followup: 12 to 23 months

Quality: Not Applicable	1	157	0.01	NR	Trabeculectomy

Antifibrosis agents	MMC

Postoperative 5-FU	7	7	31	NR

Jerndal, Lundstrom, 1980 

Europe

Followup: ≥24 months

Quality: Not Applicable	1	281	NR	NR	Trabeculectomy	None Given	NR	70	NR	29

Karlen, Sanchez, Schnyder et al., 1999

Europe

Followup: 12 to 23 months

Quality: Not Applicable	1	100	0.00	0	Antifibrosis agents

DSCI	MMC

Intraoperative 5-FU Postoperative 5-FU	NR	NR	7	0

Lamping, Bellows, Hutchinson et al., 1986

United States

Followup: ≥ 24 months

Quality: Not Applicable	1	Can't Tell	NR	0	Posterior lip sclerectomy	None Given	NR	NR	NR	61

	2	Can't Tell	NR	0	Trabeculectomy	None Given	NR	NR	NR	15

Tanihara, Negi, Akimoto 

et al., 1993

Japan

Followup: ≥24 months

Quality: Not Applicable	1	439	NR	0	Trabeculectomy 	None Given	NR	9	NR	NR

Tornqvist, Drolsum, 1991

Europe

Followup: Not Reported

Quality: Not Applicable	1	277	NR	0	Trabeculectomy	None Given	60	60	NR	NR

Watson, Jakeman, Ozturk 

et al., 1990

Europe

Followup: ≥24 months

Quality: Not Applicable	1	150	NR	NR	Trabeculectomy	None Given	NR	NR	20	8