Original ArticleMeta-analysis of randomized controlled trials in dacryocystorhinostomy with and without silicone intubation
Section snippets
Methods
The present meta-analysis considered only prospective clinical trials of primary DCR where the decision whether or not to silicone intubate was randomized. All subjects were older than 16 years. External, endonasal, and laser-assisted DCR modalities were included. Only English language articles were used.
We searched for articles, abstract reports, conference abstracts, and conference reports on Embase, PubMed, Ovid Medline, the Cochrane Central Register of Controlled Trials, Google Scholar,
Results
The study flow chart (Fig. 1) outlines the 1142 studies that were filtered to 14 RCTs.2, 3, 4, 10, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22 The 1311 DCR cases from these RCTs are summarized in Table 1.
This study analyses 1311 DCR cases from RCTs and provides adequate power to reach a conclusion, based on the sample size estimation for binary outcome parallel group superiority trials. Using a = 0.05 and power (1 − β) = 0.8, and an 87% overall success rate for DCR derived from Huang’s meta-analysis,
Conclusions
A 2017 meta-analysis of 12 RCTs with and without SI, comprising 969 DCR cases, suggested that there was a statistically significant benefit for external DCR,8 but not endonasal DCR. The aforementioned study had mislabelled forest plots, had incorrectly included a study with using a mitomycin nonstent control group,9 and was published before 3 endonasal DCR RCTs13, 21, 22 became available in 2016. Our study incorporated 14 RCTs and 1311 DCR cases.
The main limitation of our meta-analysis is the
Disclosure
The authors have no proprietary or commercial interest in any materials discussed in this article.
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