A Cochrane review [Abstract] 1 included 4 studies with a total of 551 subjects. Two studies were in Caucasian people (n=126), 1 study in black African people (n=320) and one sudy in Chinese people (n=105). Trabeculectomy with beta irradiation decreased the risk of surgical failure compared to trabeculectomy alone (RR 0.23, 95% CI 0.14 to 0.40). Beta irradiation was associated with an increased risk of cataract requiring surgical intervention (RR 2.89, 95% CI 1.39 to 6.0). The degree of improvement in success is similar to that of other antimetabolites but there is no trial data comparing beta radiation with other metabolites such as Mitomycin C or 5-Fluorouracil.
Comment: The quality of evidence is downgraded by indirectness (majority of evidence comes from one large study in black African people; results for smaller studies in Caucasian and Chinese people are of a similar order but imprecise).
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