The effectiveness of the laid-back position on lactation-related nipple problems and comfort: a meta-analysis

Abstract Background The importance of breastfeeding for maternal and child health is agreed upon worldwide. However, lactation-related nipple problems are common and are important factors affecting breastfeeding. Multiple studies recommended laid-back breastfeeding, but they are of various levels of quality, and the results are inconclusive. Methods We systematically searched the following twelve databases from inception to January 28,2020: Cochrane Library, EMBASE, Medline, Ovid, PubMed, Web of Science, CINAHL, Scopus, Chinese National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBM), WanFang, and VIP. All studies regarding laid-back breastfeeding or biological nurturing were considered, regardless of whether they were randomized controlled trials. Two trained investigators independently evaluated the quality of the selected articles and screened the data. All the data were analysed separately using Review Manager Version 5.3 and STATA/SE Version 15.1. Results A total of 12 studies involving 1936 groups of postpartum women and their newborns were included. The results of the meta-analysis showed that nipple pain (RR = 0.24; 95% CI 0.14, 0.40; p < 0.00001), nipple trauma (RR = 0.47; 95% CI 0.29, 0.75; p = 0.002) and correct latching position (RR = 1.22; 95% CI 1.11, 1.33; p < 0.0001) in the experimental groups were all better than those of the control groups, and the differences were statistically significant (p < 0.05), which indicates that the laid-back position has a positive effect on maternal breastfeeding. However, the results of position comfort showed that there was no statistical significance between the two groups (ES = 0.09; 95% CI -0.63, 0.81; p = 0.798). Conclusion Compared with traditional breastfeeding positions, the laid-back position has been proven to be related to a decreased incidence of nipple pain and nipple trauma and is seemingly conducive to the use of the correct latching position. It is suggested that the laid-back position is helpful in solving lactation-related nipple problems and can be recommended as a position for breastfeeding. However, no significant difference in position comfort was found between the two groups based on the current evidence, and further studies are still needed to validate these results due to the limitations of the included studies.

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The Effectiveness of Laid-back Position on Lactation Related Nipple problems and comfort: A meta-analysis

10.21203/rs.3.rs-40847/v2 ◽

2020 ◽

Author(s):

Zhi WANG ◽

Qiuyue LIU ◽

Lihua MIN ◽

Xiaorong MAO

Keyword(s):

Meta Analysis ◽

Current Evidence ◽

Cochrane Library ◽

Correct Position ◽

International Consensus ◽

Factors Affecting ◽

Knowledge Infrastructure ◽

Chinese National Knowledge Infrastructure ◽

Positive Effect

Abstract Background The importance of breastfeeding for maternal and child health has become an international consensus. However, it has been found that lactation-related nipple problems are common and there are some important factors affecting the breastfeeding. Multiple studies recommended the laid-back breastfeeding, but they are on various levels of quality and the results are inconclusive. Methods We systematically searched the following twelve databases: Cochrane Library, EMBASE, Medline, Ovid, PubMed, Web of Science, CINAHL, Scopus, SinoMed, Chinese National Knowledge Infrastructure (CNKI), WanFang, and VIP from inception to January 28,2020. All studies regarding the laid-back breastfeeding or biological nurturing were considered, regardless of whether they are randomized controlled trials or not. Two trained investigators independently evaluated the quality of the selected articles and screened the data. All the data were analyzed separately using Review Manager Version 5.3 and STATA/SE Version 15.1.Results A total of 12 studies involving 1,936 groups of postpartum women and their newborns were included. The results of meta-analysis showed that nipple pain (RR = 0.24; 95% CI 0.14,0.40; p < 0.00001), nipple trauma (RR = 0.47; 95% CI 0.29,0.75; p = 0.002), the correct position of latching (RR = 1.22; 95% CI 1.11,1.33; p < 0.00001) and position comfort (ES = 0.09; 95% CI -0.63,0.81; p = 0.000) of experimental groups were all better than that of the control groups, and the differences were statistically significant (p < 0.05), which indicate that the laid-back position has a positive effect on maternal breastfeeding.Conclusion Laid-back position has been proved to related with decreasing the incidence of nipple trauma and nipple pain compared with traditional breastfeeding positions, and it appears that laid-back position is conducive to the correct position of latching. However, current evidence does not show different breastfeeding outcomes in the two groups of position comfort. Laid-back position is helpful to solve lactation-related nipple problems and it can be used as a recommended position for breastfeeding.

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The Effectiveness of Laid-back Position on Lactation Related Nipple problems and comfort: A meta-analysis

10.21203/rs.3.rs-40847/v1 ◽

2020 ◽

Author(s):

Zhi WANG ◽

Qiuyue LIU ◽

Lihua MIN ◽

Xiaorong MAO

Keyword(s):

Meta Analysis ◽

Current Evidence ◽

Cochrane Library ◽

Control Group ◽

International Consensus ◽

Factors Affecting ◽

Key Words Breast ◽

Knowledge Infrastructure ◽

Chinese National Knowledge Infrastructure

Abstract Background The importance of breastfeeding for maternal and child health has become an international consensus. However, it has been found that lactation-related nipple problems are common and there are some important factors affecting the effectiveness of breastfeeding. Multiple studies recommended the laid-back breastfeeding, but the researches are on various levels of quality and the results are controversial.Methods We systematically searched the following twelve databases: Cochrane Library, EMBASE, Medline, Ovid, PubMed, Web of Science, CINAHL, Scopus, SinoMed, Chinese National Knowledge Infrastructure (CNKI), WanFang, and VIP from inception to January 28,2020. All studies reporting the laid-back breastfeeding or biological nurturing were considered, regardless of they are randomized controlled trials. Two trained investigators independently evaluated the quality of the included the articles and screened the data. All the data were analyzed separately using Review Manager Version 5.3 and STATA/SE Version 15.1. Results A total of 12 studies involving 1,936 groups of postpartum women and their newborns were included. The results of meta-analysis showed that nipple trauma (RR = 0.47; 95% CI 0.29,0.75; p < 0.002), nipple pain (RR = 0.25; 95% CI 0.20,0.32; p < 0.00001), the correct posture of latching (RR = 1.22; 95% CI 1.11,1.33; p < 0.00001)and position comfort (ES = 0.01; 95%CI -0.28,0.30; p = 0.006) of experimental group were all better than control group, and the differences were statistically significant ( p < 0.05), which indicates that the laid-back position has a positive effect on maternal breastfeeding. Conclusion Laid-back position has significant advantages in decreasing the incidence of nipple trauma and nipple pain compared with traditional breastfeeding postures, and it appears that laid-back position is conducive to the correct posture of latching. However, current evidence does not show different breastfeeding outcomes in the two groups of position comfort. Laid-back position is helpful to solve lactation-related nipple problems and it can be used as a recommended position for breastfeeding. Key words: Breast-feeding, Biological Nurturing, Laid-back Breastfeeding, Meta-Analysis

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The Effectiveness and Safety of Moxibustion for Peripheral Facial Paralysis：A Protocol for Systematic Review and Meta-Analysis

10.21203/rs.3.rs-549760/v1 ◽

2021 ◽

Author(s):

Shanshan Xiang ◽

Ting Fang ◽

Changan Ren ◽

Junnan Qi ◽

Zheng Guo ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Document Retrieval ◽

Effective Rate ◽

Cochrane Library ◽

Peripheral Facial Paralysis ◽

Randomized Controlled ◽

Knowledge Infrastructure ◽

Chinese National Knowledge Infrastructure

Abstract Background: Moxibustion has been used in treating patients with Peripheral Facial Paralysis(PFP), but its effectiveness and safety have not been systematically evaluated. Therefore, the objective of this review is to comprehensively assess the effectiveness and safety of moxibustion for PFP.Methods: We will conduct a systematic document retrieval of databases from inception to March 18, 2021, including Embase, Cochrane Library, Pubmed, Chinese databases SinoMed, Chinese National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database and Wanfang Data (WF). Reviewers will independently retrieve databases, identify trials, extract data, and evaluate the quality of eligible randomized controlled trials(RCTs). The outcomes will include: the effective rate, the House-Brackmann (H-B) score, Facial Disability Index (FDI), and side effects. The quality of eligible RCT will be assessed by the Cochrane risk-of-bias. Meta-analysis will be processed by the Cochrane Collaboration’s RevMan 5.3.0.Discussion: This review will provide comprehensive evidence of moxibustion for PFP.Systematic review registration: PROSPERO CRD42020207068

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Efficacy of Qigong Exercise for Treatment of Fatigue: A Systematic Review and Meta-Analysis

Frontiers in Medicine ◽

10.3389/fmed.2021.684058 ◽

2021 ◽

Vol 8 ◽

Author(s):

Rui Wang ◽

Xueyan Huang ◽

Yeqi Wu ◽

Dai Sun

Keyword(s):

Meta Analysis ◽

Chronic Fatigue ◽

Cochrane Library ◽

China National Knowledge Infrastructure ◽

Patients With Cancer ◽

Fatigue Syndrome ◽

Knowledge Infrastructure ◽

Standard Mean Difference ◽

Significant Difference

Objective: Several studies suggested that Qigong exercise (QE) can relieve fatigue in patients diagnosed with various diseases. Our review aimed to evaluate the efficacy of QE for alleviating fatigue.Methods: A related literature search was performed in the PubMed, Web of Science, Embase, Cochrane Library, China Biology Medicine disc (CBM), China National Knowledge Infrastructure (CNKI), Wanfang, and VIP data bases from inception to November 2020. Information on fatigue, malaise, tiredness, and Qigong research data was collected.Results: Sixteen randomized controlled trials (RCTs) were reported in patients with cancer (n = 4), chronic fatigue syndrome (n = 2), and other diseases (n = 10). The QE groups showed significant improvements in total fatigue intensity [15 RCTs, p < 0.00001; standard mean difference (SMD) −0.69 (−0.95 to −0.44)]. The QE groups did not show significant improvement in quality of life [4 RCTs, p = 0.08; SMD 0.53 (−0.07 to 1.14)]. The statistically significant difference of the subgroup analyses (different primary diseases, QE types, and study quality) also remained unchanged.Conclusion: The findings of this meta-analysis indicate that QE may be beneficial for improving fatigue in patients diagnosed with various diseases. Considering the limitations of the study, we draw a very cautious conclusion regarding the resulting estimate of the effect. Further studies are warranted to better understand the benefits of QE in primary medical care.

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Effects of Novel Anti-VEGF Agents with Intravitreal Conbercept in Diabetic Retinopathy: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/9357108 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Hui Wang ◽

Jing Zhou ◽

Caoyu Sun ◽

Xu Dong

Keyword(s):

Diabetic Retinopathy ◽

Meta Analysis ◽

Current Evidence ◽

Cochrane Library ◽

Efficacy And Safety ◽

China National Knowledge Infrastructure ◽

Intravitreal Triamcinolone ◽

Knowledge Infrastructure ◽

The Mean

To evaluate the efficacy and safety of intravitreal conbercept (IVC) for diabetic retinopathy (DR) compared with intravitreal triamcinolone acetonide (IVTA). PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP database, and Wanfang database were searched from their earliest records to January 2020. We included randomized controlled trials (RCTs) evaluating the efficacy and safety of conbercept in DR patients compared with ITVA. Outcomes included the mean changes from the baseline in best corrected visual acuity (BCVA) score, central macular thickness (CMT), quality of life (QoL) over time, and the incidence of adverse events (AEs). A total of 19 RCTs involving 1,811 eyes were included in this meta-analysis. IVC might improve BCVA (WMD = 0.10, 95% CI (0.07, 0.12), P < 0.001 ) and reduce CMT (WMD = −102.5, 95% CI (−148.48, −56.53), P < 0.001 ) compared to IVTA. The incidence of AEs in patients receiving IVC was significantly lower than those receiving IVTA (RR = 0.29, 95% CI (0.21, 0.40), P < 0.001 ). Patients with IVC treatments acquired better self-care, mobility, social, and mental scores compared with IVTA ( P < 0.001 ). Current evidence shows that IVC has better effects and safety than IVTA in treating DR, and it can significantly enhance the QoL of patients with DR.

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Efficacy Comparison of Different Acupuncture Treatments for Primary Insomnia: A Bayesian Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2019/8961748 ◽

2019 ◽

Vol 2019 ◽

pp. 1-13 ◽

Cited By ~ 6

Author(s):

Huachong Xu ◽

Yucong Shi ◽

Yike Xiao ◽

Pei Liu ◽

Sizhi Wu ◽

...

Keyword(s):

Meta Analysis ◽

Scalp Acupuncture ◽

Primary Insomnia ◽

Sufficient Evidence ◽

Cochrane Library ◽

China National Knowledge Infrastructure ◽

Knowledge Infrastructure ◽

Significant Difference ◽

Indirect Comparisons

Background. Acupuncture treatments are used frequently in the treatment of primary insomnia considering its less side effect. However, most treatment choices are made just based on personal experience among different forms of acupuncture. This study compared the effectiveness of different forms of acupuncture for primary insomnia by using network meta-analysis. Methods. All randomized controlled trials (RCTs) of acupuncture treatments for primary insomnia were searched in seven databases from the date of database inception to January 6, 2019, including PubMed, Web of Science, Embase, Cochrane Library, Wanfang database, China National Knowledge Infrastructure (CNKI) database, and VIP Chinese Science and Technique Journals (CQVIP) database. After screening, the effectiveness rate was extracted from the included RCTs as primary outcomes. The network meta-analysis was performed by Review Manager 5.3, Stata13.0, and GeMTC 0.14.3. Results. Forty-two studies were included, which contained 3304 participants among 6 interventions. Based on the ranking probability and compared to western medicine, scalp acupuncture (OR = 8.12, 95% CI (4.07,16.81)) is considered to be the most effective method, followed by electroacupuncture (OR = 6.29, 95% CI (3.36, 12.67)), electroacupuncture combined scalp acupuncture (OR = 5.20, 95% CI (2.43,11.28)), warm acupuncture (OR = 3.79, 95% CI (1.85,8.16)), and conventional acupuncture (OR = 2.86, 95% CI (2.05,3.95)). There was no significant difference between the results of direct and indirect comparisons. Conclusions. The finding indicated that five acupuncture methods may be all effective in the treatment of primary insomnia, and scalp acupuncture seems to be the best treatment. However, the overall quality of the included trials could only be ranked as medium to low quality, and higher quality RCTs are warranted for sufficient evidence.

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The Effectiveness of Acupuncture in Management of Functional Constipation: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2020/6137450 ◽

2020 ◽

Vol 2020 ◽

pp. 1-17

Author(s):

Lu Wang ◽

Mingmin Xu ◽

Qianhua Zheng ◽

Wei Zhang ◽

Ying Li

Keyword(s):

Quality Of Life ◽

Meta Analysis ◽

Safety Evaluation ◽

Functional Constipation ◽

Responder Rate ◽

Current Evidence ◽

Cochrane Library ◽

China National Knowledge Infrastructure ◽

Increased Risk

Objective. The purpose of this study was to assess the effectiveness and safety of acupuncture for functional constipation (FC). Methods. A rigorous literature search was performed in English (PubMed, Web of Science, the Cochrane Library, and EMBASE) and Chinese (China National Knowledge Infrastructure (CNKI), Chinese Biological Medical (CBM), Wanfang database, and China Science and Technology Journal (VIP)) electronic databases from their inception to October 2019. Included randomized controlled trials (RCTs) compared acupuncture therapy with sham acupuncture or pharmacological therapies. The outcome measures were evaluated, including the primary outcome of complete spontaneous bowel movement (CSBM) and secondary outcomes of Bristol Stool Form Scale (BSFS), constipation symptoms scores (CSS), responder rate, the Patient Assessment of Constipation Quality of Life (PAC-QOL) questionnaire, and safety evaluation. Meta-analysis was performed by using RevMan5.3. Results. The merged data of 28 RCTs with 3525 participants indicated that acupuncture may be efficient for FC by increasing CSBMs (p<0.00001; MD = 0.84 [95% CI, 0.65 to 1.03]; I2 = 0%) and improving constipation symptoms (p=0.03; SMD = −0.4 [95% CI, −0.78 to −0.03]; I2 = 74%), stool formation (p<0.00001; MD = 0.24 [95% CI, 0.15 to 0.34]; I2 = 0%), quality of life (p<0.00001; N = 1, MD = −0.33 [95% CI, −0.45 to −0.21]), and responder rates (p=0.02; RR = 2.16; [95% CI, 1.1 to 4.24]; I2 = 69%) compared with the effects of sham treatment. No increased risk of adverse events was observed (p=0.44; RR = 1.18; [95% CI, 0.77 to 1.81]; I2 = 0%). With regard to medication comparisons, the pooled data indicated that acupuncture was more effective in increasing CSBMs (p=0.004; MD = 0.53 [95% CI, 0.17 to 0.88]; I2 = 88%) and improving patients’ quality of life (p<0.00001; SMD = −0.73 [95% CI, −1.02 to −0.44]; I2 = 64%), with high heterogeneity. However, there were no significant differences in responder rate (p=0.12; RR = 1.31; [95% CI, 0.94 to 1.82]; I2 = 53%), BSFS (p=0.5; MD = 0.17 [95% CI, −0.33 to 0.68]; I2 = 93%), or CSS (p=0.05; SMD = −0.62 [95% CI, −1.23 to −0.01]; I2 = 89%). Regarding safety evaluation, acupuncture was safer than medications (p<0.0001; RR = 0.3; [95% CI, 0.18 to 0.52]; I2 = 30%). Conclusions. Current evidence suggests that acupuncture is an efficient and safe treatment for FC. Acupuncture increased stool frequency, improved stool formation, alleviated constipation symptoms, and improved quality of life. However, the evidence quality was relatively low and the relationship between acupuncture and drugs is not clear. More high-quality trials are recommended in the future. PROSPERO registration number: CRD42019143347.

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Kinesio Taping for Balance Function after Stroke: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2019/8470235 ◽

2019 ◽

Vol 2019 ◽

pp. 1-15 ◽

Cited By ~ 4

Author(s):

Yijuan Hu ◽

Dongling Zhong ◽

Qiwei Xiao ◽

Qiang Chen ◽

Juan Li ◽

...

Keyword(s):

Systematic Review ◽

Treatment Duration ◽

Meta Analysis ◽

Current Evidence ◽

Cochrane Library ◽

Clinical Effects ◽

Balance Function ◽

Balance Impairment ◽

Kinesio Taping ◽

Significant Difference

Objective. With the increasing social and economic burdens of balance impairment after stroke, the treatment for balance impairment after stroke becomes a major public health problem worldwide. Kinesio taping (KT) as a part of clinical practice has been used widely in the treatment of balance impairment after stroke. However, the clinical effects of KT for balance function have not been confirmed. The objective of this study is to investigate the effects and safety of KT for balance impairment after stroke. Methods. We conducted a systematic review (SR) and meta-analysis of randomized controlled trials (RCTs) on the effects of KT for balance impairment after stroke. We searched the following databases: (1) English databases: EMBASE (via Ovid), MEDLINE (via Ovid), the Cochrane library, PubMed, and PEDro; (2) Chinese databases: China Biology Medicine (CBM), Wan Fang database, China National Knowledge Infrastructure (CNKI), and VIP. Besides, hand searches of relevant references were also conducted. We systematically searched from the inception to December 2018, using the keywords (Kinesio, Kinesio Tape, tape, or Orthotic Tape) and (stroke, hemiplegia, or hemiplegic paralysis) and (balance or stability). The search strategies were adjusted for each database. The reference lists of included articles were reviewed for relevant trials. For missing data, we contacted the authors to get additional information. Results. 22 RCTs involved 1331 patients, among which 667 patients in the experimental group and 664 patients in the control group were included. Results of meta-analysis showed that, compared with conventional rehabilitation (CR), there was significant difference in Berg Balance Scale (BBS) (MD=4.46, 95%CI 1.72 to 7.19, P=0.001), Time Up and Go Test (TUGT) (MD=-4.62, 95%CI -5.48 to -3.79, P < 0.00001), functional ambulation category scale (FAC) (MD=0.53, 95%CI 0.38 to 0.68, P < 0.00001), Fugl-Meyer assessment (FMA-L) (MD=4.20, 95%CI 3.17 to 5.24, P < 0.00001), and Modified Ashworth Scale (MAS) (MD=-0.38, 95%CI -0.49 to -0.27, P < 0.00001). The results of subgroup analysis showed that there was no significant difference between KT and CR with ≤4 weeks treatment duration (< 4 weeks: MD=5.03, 95%CI -1.80 to 11.85, P=0.15; =4 weeks: MD=4.33, 95%CI -1.50 to 10.15, P=0.15), while there was significant difference with more than 4-week treatment duration (MD=4.77, 95%CI 2.58 to 6.97, P < 0.0001). Conclusions. Based on current evidence, KT was more effective than CR for balance function, lower limb function, and walking function in poststroke patients. Longer treatment duration may be associated with better effects. However, more well-conducted RCTs are required in the future.

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Efficacy and Safety of Modified Yunu-Jian in Patients with Periodontitis: A Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/5147439 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Yuanyuan Yue ◽

Meng Gao ◽

Yanru Deng ◽

Jiemin Shao ◽

Yingguang Sun

Keyword(s):

Western Medicine ◽

Combined Therapy ◽

Meta Analysis ◽

Effective Rate ◽

Cochrane Library ◽

Efficacy And Safety ◽

China National Knowledge Infrastructure ◽

Knowledge Infrastructure ◽

Oral Inflammation

Background. Modified Yunu-Jian (mYJ), a Chinese medicine (CM) formula, is thought to clear heat and nourish yin. Clinically, it is often used to treat oral inflammation. However, its efficacy remains controversial. Methods. The study aims to evaluate the efficacy and safety of mYJ for treating patients with periodontitis. We searched electronic databases (PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang database, VIP database, and CBM) from inception to December 2020. Only randomized controlled trials investigating modified Yunu-Jian, with or without other medications, against controlled intervention in the treatment of patients diagnosed with periodontitis were included. Both Review Manager 5.3 and Stata 15.0 software were used to analyze the data. The Cochrane Collaborations risk of bias tool was used to assess the quality of the methods. Results. Thirteen clinical trials, involving 1179 participants, were included in our investigation. The results showed that the combination of mYJ with western medicine improved the total effective rate compared with western medicine alone (RR = 1.17, 95% CI (1.12, 1.23), P < 0.00001). The sensitivity analysis and Harbord’s test ( P = 0.255) both showed that the results were statistically robust. Moreover, the periodontal indexes (GI, SBI, PLI, and PD; P < 0.00001) of patients with periodontitis were also significantly improved after receiving the combined therapy. No serious adverse reactions were observed in the experimental groups. Conclusions. Evidence from the meta-analysis suggested that mYJ appeared to be effective and relatively safe for treating periodontitis. Because of the low quality of the methods used in the included RCTs, further studies with larger sample sizes and well-designed models are required to confirm our findings.

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Comparison between Ologen implant and Mitomycin C in trabeculectomy: A Systematic Review and Meta-Analysis

10.21203/rs.2.10619/v1 ◽

2019 ◽

Author(s):

Xiaoyan Liu ◽

Yali Du ◽

Min Lei ◽

Leyi Zhuang ◽

Peng Lv

Keyword(s):

Adverse Events ◽

Success Rate ◽

Data Extraction ◽

Meta Analysis ◽

Collagen Matrix ◽

Current Evidence ◽

Cochrane Library ◽

Significant Difference ◽

Mean Differences ◽

Alternative Choice

Abstract Objective To evaluate the effectiveness and safety of the biodegradable collagen matrix (Ologen) implant in trabeculectomy. Research design and methods We searched Pubmed, Cochrane library, Embase and Web of Science databases to find studies that met our pre-stated inclusion criteria. Reference lists of retrieved articles were also reviewed. The search was finished by February 2019. Study selection, data extraction, quality assessment, and data analyses were performed according to the Cochrane standards. Either a fixed or a random-effects model was used to calculate the overall combined risk estimates. The efficacy measures were the weighted mean differences (WMDs) for the intraocular pressure reduction (IOPR) and the glaucoma medications reduction, the odds ratio (OR) for the success rate and adverse events. Results Fifteen randomized controlled trials involved 682 eyes were included in the meta-analysis. There were no statistically differences between two groups in the IOPR at any time postoperatively. The MD of the IOPR was [MD= -0.45,95% Confidence Interval (CI), (-2.36,1.46), P=0.65] at one day, [MD= -0.82,95% CI, (-1.97, 0.33), P=0.16] at one week, [MD= -1.33, 95% CI,(-3.12, 0.47), P=0.15] at one month, [MD= 0.11,95% CI, (-1.87, 2.08), P=0.92] at three months, [MD= -0.60,95% CI, (-2.27, 1.06), P=0.48] at six months, [MD= -0.33,95% CI, (-1.99, 1.32), P=0.69] at one year, [MD= -0.13,95% CI, (-1.90, 1.65), P=0.89] at two years, [MD= 2.54,95% CI, (-2.83, 7.90), P=0.35] at three years, [MD= 3.04,95% CI, (-3.95, 10.03), P=0.39] at five years. There was no statistically significant difference between the Ologen groups and MMC groups concerned the complete success rate [OR=1.19, 95%CI, (0.83, 1.71), P=0.35]. With regard to the adverse events, no obvirously significance was observed. Seven studies reported the change of antiglaucoma medications. We found that the change of antiglaucoma medications is higher in MMC groups than that in Ologen groups [MD=-0.18, 95%CI, (-0.33, -0.03), P=0.02]. There is no significant difference in complications between the two groups. Conclusions From the current evidence, Ologen may be an alternative choice for trabeculectomy when considering the efficacy and safety. However, MMC might be the preferred choice concerned cost-effectiveness.

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