Aqueous shunts for glaucoma

Victoria L Tseng; Anne L Coleman; Melinda Y Chang; Joseph Caprioli

doi:10.1002/14651858.CD004918.pub3

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Figure 1

Study flow diagram.

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Figure 2

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

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Figure 3

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

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Analysis 1.1

Comparison 1 Aqueous shunts versus trabeculectomy for glaucoma, Outcome 1 Mean intraocular pressure.

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Analysis 1.2

Comparison 1 Aqueous shunts versus trabeculectomy for glaucoma, Outcome 2 Intraocular pressure outcomes at 1 year follow‐up.

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Analysis 1.3

Comparison 1 Aqueous shunts versus trabeculectomy for glaucoma, Outcome 3 Intraocular pressure outcomes at 3 years follow‐up.

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Analysis 1.4

Comparison 1 Aqueous shunts versus trabeculectomy for glaucoma, Outcome 4 Intraocular pressure outcomes at 5 years follow‐up.

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Analysis 1.5

Comparison 1 Aqueous shunts versus trabeculectomy for glaucoma, Outcome 5 Mean difference in logMAR visual acuity.

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Analysis 1.6

Comparison 1 Aqueous shunts versus trabeculectomy for glaucoma, Outcome 6 Mean change in visual field.

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Analysis 1.7

Comparison 1 Aqueous shunts versus trabeculectomy for glaucoma, Outcome 7 Mean antiglaucoma medications.

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Analysis 1.8

Comparison 1 Aqueous shunts versus trabeculectomy for glaucoma, Outcome 8 Need for reoperation to control glaucoma progression.

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Analysis 1.9

Comparison 1 Aqueous shunts versus trabeculectomy for glaucoma, Outcome 9 Complications at 1 year follow‐up.

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Analysis 1.10

Comparison 1 Aqueous shunts versus trabeculectomy for glaucoma, Outcome 10 Complications at 3 years follow‐up.

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Analysis 1.11

Comparison 1 Aqueous shunts versus trabeculectomy for glaucoma, Outcome 11 Complications at 4 years follow‐up.

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Analysis 1.12

Comparison 1 Aqueous shunts versus trabeculectomy for glaucoma, Outcome 12 Complications at 5 years follow‐up.

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Comparison 2 Ahmed implant versus 350 mm2 Baerveldt implant for glaucoma, Outcome 1 Mean intraocular pressure.

Analysis 2.1

Comparison 2 Ahmed implant versus 350 mm² Baerveldt implant for glaucoma, Outcome 1 Mean intraocular pressure.

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Comparison 2 Ahmed implant versus 350 mm2 Baerveldt implant for glaucoma, Outcome 2 Mean logMAR visual acuity.

Analysis 2.2

Comparison 2 Ahmed implant versus 350 mm² Baerveldt implant for glaucoma, Outcome 2 Mean logMAR visual acuity.

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Comparison 2 Ahmed implant versus 350 mm2 Baerveldt implant for glaucoma, Outcome 3 Mean number of antiglaucoma medications.

Analysis 2.3

Comparison 2 Ahmed implant versus 350 mm² Baerveldt implant for glaucoma, Outcome 3 Mean number of antiglaucoma medications.

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Comparison 2 Ahmed implant versus 350 mm2 Baerveldt implant for glaucoma, Outcome 4 Need for reoperation to control glaucoma progression.

Analysis 2.4

Comparison 2 Ahmed implant versus 350 mm² Baerveldt implant for glaucoma, Outcome 4 Need for reoperation to control glaucoma progression.

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Comparison 2 Ahmed implant versus 350 mm2 Baerveldt implant for glaucoma, Outcome 5 Complications at 1 year follow‐up.

Analysis 2.5

Comparison 2 Ahmed implant versus 350 mm² Baerveldt implant for glaucoma, Outcome 5 Complications at 1 year follow‐up.

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Comparison 2 Ahmed implant versus 350 mm2 Baerveldt implant for glaucoma, Outcome 6 Complications at 3 years follow‐up.

Analysis 2.6

Comparison 2 Ahmed implant versus 350 mm² Baerveldt implant for glaucoma, Outcome 6 Complications at 3 years follow‐up.

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Comparison 2 Ahmed implant versus 350 mm2 Baerveldt implant for glaucoma, Outcome 7 Complications at 5 years follow‐up.

Analysis 2.7

Comparison 2 Ahmed implant versus 350 mm² Baerveldt implant for glaucoma, Outcome 7 Complications at 5 years follow‐up.

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Analysis 3.1

Comparison 3 Ahmed implant versus single‐plate Molteno implant for glaucoma, Outcome 1 Mean intraocular pressure at 2 years follow‐up.

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Analysis 3.2

Comparison 3 Ahmed implant versus single‐plate Molteno implant for glaucoma, Outcome 2 Intraocular pressure outcomes at 2 years follow‐up.

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Analysis 3.3

Comparison 3 Ahmed implant versus single‐plate Molteno implant for glaucoma, Outcome 3 Mean logMAR visual acuity at 2 years follow‐up.

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Analysis 3.4

Comparison 3 Ahmed implant versus single‐plate Molteno implant for glaucoma, Outcome 4 Visual field mean deviation at 2 years follow‐up.

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Analysis 3.5

Comparison 3 Ahmed implant versus single‐plate Molteno implant for glaucoma, Outcome 5 Mean number of antiglaucoma medications at 2 years follow‐up.

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Analysis 3.6

Comparison 3 Ahmed implant versus single‐plate Molteno implant for glaucoma, Outcome 6 Complications at 2 years follow‐up.

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Analysis 4.1

Comparison 4 Double‐plate Molteno implant versus Schocket shunt for glaucoma, Outcome 1 Mean intraocular pressure at 6 months follow‐up.

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Analysis 4.2

Comparison 4 Double‐plate Molteno implant versus Schocket shunt for glaucoma, Outcome 2 Complications at 6 to 12 months follow‐up.

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Analysis 5.1

Comparison 5 Ahmed implant with early aqueous suppression versus Ahmed implant with standard medication regimen for glaucoma, Outcome 1 Mean intraocular pressure.

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Analysis 5.2

Comparison 5 Ahmed implant with early aqueous suppression versus Ahmed implant with standard medication regimen for glaucoma, Outcome 2 Mean logMAR visual acuity.

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Analysis 5.3

Comparison 5 Ahmed implant with early aqueous suppression versus Ahmed implant with standard medication regimen for glaucoma, Outcome 3 Mean antiglaucoma medications.

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Analysis 6.1

Comparison 6 Ahmed implant with anti‐VEGF versus Ahmed implant alone for glaucoma, Outcome 1 Mean intraocular pressure.

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Analysis 6.2

Comparison 6 Ahmed implant with anti‐VEGF versus Ahmed implant alone for glaucoma, Outcome 2 Mean antiglaucoma medications.

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Analysis 7.1

Comparison 7 Ahmed implant with intravitreal triamcinolone versus Ahmed implant alone for neovascular glaucoma, Outcome 1 Mean intraocular pressure at 1 year follow‐up.

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Analysis 7.2

Comparison 7 Ahmed implant with intravitreal triamcinolone versus Ahmed implant alone for neovascular glaucoma, Outcome 2 Complete success at 1 year follow‐up.

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Analysis 7.3

Comparison 7 Ahmed implant with intravitreal triamcinolone versus Ahmed implant alone for neovascular glaucoma, Outcome 3 Mean antiglaucoma medications at 1 year follow‐up.

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Analysis 7.4

Comparison 7 Ahmed implant with intravitreal triamcinolone versus Ahmed implant alone for neovascular glaucoma, Outcome 4 Complications at 1 year follow‐up.

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Analysis 8.1

Comparison 8 Ahmed implant with shunt augmentation versus Ahmed implant without shunt augmentation for glaucoma, Outcome 1 Mean intraocular pressure.

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Analysis 8.2

Comparison 8 Ahmed implant with shunt augmentation versus Ahmed implant without shunt augmentation for glaucoma, Outcome 2 Intraocular pressure outcomes at 6 months follow‐up.

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Analysis 8.3

Comparison 8 Ahmed implant with shunt augmentation versus Ahmed implant without shunt augmentation for glaucoma, Outcome 3 Intraocular pressure outcomes at 1 year follow‐up.

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Analysis 8.4

Comparison 8 Ahmed implant with shunt augmentation versus Ahmed implant without shunt augmentation for glaucoma, Outcome 4 Postoperative hypertensive phase.

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Analysis 8.5

Comparison 8 Ahmed implant with shunt augmentation versus Ahmed implant without shunt augmentation for glaucoma, Outcome 5 Mean antiglaucoma medications at 6 months follow‐up.

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Analysis 8.6

Comparison 8 Ahmed implant with shunt augmentation versus Ahmed implant without shunt augmentation for glaucoma, Outcome 6 Complications at 6 months follow‐up.

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Analysis 8.7

Comparison 8 Ahmed implant with shunt augmentation versus Ahmed implant without shunt augmentation for glaucoma, Outcome 7 Complications at 1 year follow‐up.

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Analysis 9.1

Comparison 9 Ahmed implant with partial tube ligation versus Ahmed implant with no ligation for glaucoma, Outcome 1 Mean intraocular pressure at 6 months follow‐up.

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Analysis 9.2

Comparison 9 Ahmed implant with partial tube ligation versus Ahmed implant with no ligation for glaucoma, Outcome 2 Intraocular pressure outcomes at 6 months follow‐up.

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Analysis 9.3

Comparison 9 Ahmed implant with partial tube ligation versus Ahmed implant with no ligation for glaucoma, Outcome 3 Complications at 6 months follow‐up.

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Analysis 10.1

Comparison 10 Pars plana versus conventional Ahmed implant for glaucoma with penetrating keratoplasty, Outcome 1 Mean intraocular pressure at 2 years follow‐up.

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Analysis 10.2

Comparison 10 Pars plana versus conventional Ahmed implant for glaucoma with penetrating keratoplasty, Outcome 2 Intraocular pressure outcomes at 2 years follow‐up.

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Analysis 10.3

Comparison 10 Pars plana versus conventional Ahmed implant for glaucoma with penetrating keratoplasty, Outcome 3 Visual acuity improvement of 2 lines or more on Snellen chart at 2 years follow‐up.

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Analysis 10.4

Comparison 10 Pars plana versus conventional Ahmed implant for glaucoma with penetrating keratoplasty, Outcome 4 Complications at 2 years follow‐up.

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Analysis 11.1

Comparison 11 Ahmed model M4 versus Ahmed model S2 for neovascular glaucoma, Outcome 1 Mean intraocular pressure at 1 year follow‐up.

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Analysis 11.2

Comparison 11 Ahmed model M4 versus Ahmed model S2 for neovascular glaucoma, Outcome 2 Visual acuity between 20/20 and 20/100 at 1 year follow‐up.

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Analysis 11.3

Comparison 11 Ahmed model M4 versus Ahmed model S2 for neovascular glaucoma, Outcome 3 Complications 1 day after surgery.

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Comparison 12 500 mm2 Baerveldt implant versus 350 mm2 Baerveldt implant for non‐neovascular glaucoma, Outcome 1 Mean intraocular pressure.

Analysis 12.1

Comparison 12 500 mm² Baerveldt implant versus 350 mm² Baerveldt implant for non‐neovascular glaucoma, Outcome 1 Mean intraocular pressure.

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Comparison 12 500 mm2 Baerveldt implant versus 350 mm2 Baerveldt implant for non‐neovascular glaucoma, Outcome 2 Intraocular pressure outcomes.

Analysis 12.2

Comparison 12 500 mm² Baerveldt implant versus 350 mm² Baerveldt implant for non‐neovascular glaucoma, Outcome 2 Intraocular pressure outcomes.

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Comparison 12 500 mm2 Baerveldt implant versus 350 mm2 Baerveldt implant for non‐neovascular glaucoma, Outcome 3 Complications at 5 years follow‐up.

Analysis 12.3

Comparison 12 500 mm² Baerveldt implant versus 350 mm² Baerveldt implant for non‐neovascular glaucoma, Outcome 3 Complications at 5 years follow‐up.

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Analysis 13.1

Comparison 13 Single‐plate Molteno implant with oral corticosteroids versus single‐plate Molteno implant alone for glaucoma, Outcome 1 Mean intraocular pressure at 6 months follow‐up.

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Analysis 13.2

Comparison 13 Single‐plate Molteno implant with oral corticosteroids versus single‐plate Molteno implant alone for glaucoma, Outcome 2 Intraocular pressure outcomes at 6 months follow‐up.

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Analysis 13.3

Comparison 13 Single‐plate Molteno implant with oral corticosteroids versus single‐plate Molteno implant alone for glaucoma, Outcome 3 Visual acuity within 1 Snellen line or improved at 6 months follow‐up.

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Analysis 13.4

Comparison 13 Single‐plate Molteno implant with oral corticosteroids versus single‐plate Molteno implant alone for glaucoma, Outcome 4 Mean antiglaucoma medications at 6 months follow‐up.

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Analysis 13.5

Comparison 13 Single‐plate Molteno implant with oral corticosteroids versus single‐plate Molteno implant alone for glaucoma, Outcome 5 Need for reoperation to control glaucoma progression.

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Analysis 13.6

Comparison 13 Single‐plate Molteno implant with oral corticosteroids versus single‐plate Molteno implant alone for glaucoma, Outcome 6 Complications at 6 months follow‐up.

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Summary of findings for the main comparison. Aqueous shunts versus trabeculectomy

Aqueous shunts compared with trabeculectomy for glaucoma
Population: People with glaucoma Settings: Glaucoma surgery Intervention: Aqueous shunt (Ahmed or Baerveldt) Comparison: Trabeculectomy
Outcomes	*Illustrative comparative risks (95% CI)**		Relative effect (95% CI)	No. of participants (studies)	Certainty of the evidence (GRADE)	Comments
Outcomes	Assumed risk: Trabeculectomy	Corresponding risk: Aqueous shunt	Relative effect (95% CI)	No. of participants (studies)	Certainty of the evidence (GRADE)	Comments
Mean IOP at 1‐year follow‐up	The mean IOP ranged across trabeculectomy groups from 11.4 mmHg to 13.8 mmHg.	The mean IOP in the aqueous shunt groups was 2.55 mmHg higher (0.78 lower to 5.87 mmHg higher).	MD 2.55 mmHg (‐0.78 mmHg to 5.87 mmHg)	380 (3 studies)	⊕⊝⊝⊝ very low^1,2,3
Mean logMAR visual acuity at 1‐year follow‐up	The mean change in logMAR visual acuity ranged across trabeculectomy groups from ‐0.29 units to 5.77 units.	The mean logMAR visual acuity in the aqueous shunt groups was 0.12 units higher (0.07 units lower to 0.31 units higher).	MD 0.12 units (‐0.07 units to 0.31 units)	380 (3 studies)	⊕⊝⊝⊝ very low^1,2,3
Mean change in visual field score from baseline at 1‐year follow‐up	The mean change in visual field score ranged across trabeculectomy groups from 0.09 to 1.09.	The mean change in visual field score in the aqueous shunt groups was 0.25 lower (1.91 lower to 1.40 higher).	MD ‐0.25 (‐1.91 to 1.40)	196 (2 studies)	⊕⊝⊝⊝ very low^1,3,4	1 trial did not report visual field outcomes.
Mean number of antiglaucoma medications at 1‐year follow‐up	The mean number of antiglaucoma medications in the trabeculectomy group was 0.5.	The mean number of antiglaucoma medications in the aqueous shunt group was 0.80 higher (0.48 to 1.12 higher).	MD 0.80 (0.48 to 1.12)	184 (1 study)	⊕⊕⊝⊝ low^1,4	2 trials reported that the mean number of antiglaucoma medications was higher in the aqueous shunt group than in the trabeculectomy group, but reported insufficient data for analysis.
Proportion needing additional glaucoma surgery at 1‐year follow‐up	36 per 1000	9 per 1000 (1 to 49)	RR 0.24 (0.04 to 1.36)	329 (2 studies)	⊕⊝⊝⊝ very low^1,2,3	1 trial reported reoperation data at 4 years' follow‐up only.
Adverse events up to 1‐year follow‐up	571 per 1000	337 per 1000 (246 to 463)	RR 0.59 (0.43 to 0.81)	212 (1 study)	⊕⊝⊝⊝ very low^1,2,3	2 trials reported specific adverse events (e.g. flat anterior chamber, choroidal effusion, hyphema), but not overall number of adverse events.
Quality of life at 1‐year follow‐up	Not reported	Not reported	‐	‐	‐
The basis for the assumed risk* is the mean control group risk across studies. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% confidence interval). CI: confidence interval; IOP: intraocular pressure; MD: mean difference; RR: risk ratio
GRADE Working Group grades of evidence High certainty: Further research is very unlikely to change our confidence in the estimate of effect. Moderate certainty: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low certainty: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low certainty: We are very uncertain about the estimate.
¹Downgraded (‐1) for high or unclear risk of bias among included trials. ²Downgraded (‐1) for heterogeneity or inconsistency across trials. ³Downgraded (‐1) for imprecision of results (wide confidence intervals). ⁴Downgraded (‐1) for high probability of publication bias (selectively not reported from included trials).

Summary of findings for the main comparison. Aqueous shunts versus trabeculectomy

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Summary of findings 2. Ahmed implant versus Baerveldt implant

Ahmed implant compared with Baerveldt implant for glaucoma
Population: People with glaucoma Settings: Glaucoma surgery Intervention: Ahmed implant Comparison: Baerveldt implant (350 mm²)
Outcomes	*Illustrative comparative risks (95% CI)**		Relative effect (95% CI)	No. of participants (studies)	Certainty of the evidence (GRADE)	Comments
Outcomes	Assumed risk: Baerveldt implant	Corresponding risk: Ahmed implant	Relative effect (95% CI)	No. of participants (studies)	Certainty of the evidence (GRADE)	Comments
Mean IOP at 1‐year follow‐up	The mean IOP ranged across Baerveldt implant groups from 13.2 mmHg to 13.6 mmHg.	The mean IOP in the Ahmed implant groups was 2.60 mmHg higher (1.58 mmHg to 3.62 mmHg higher).	MD 2.60 mmHg (1.58 mmHg to 3.62 mmHg)	464 (2 studies)	⊕⊕⊕⊝ moderate¹
Mean logMAR visual acuity at 1‐year follow‐up	The mean logMAR visual acuity ranged across Baerveldt implant groups from 1.23 to 1.5 logMAR units.	The mean logMAR visual acuity in the Ahmed implant groups was 0.07 units lower (0.27 units lower to 0.13 units higher).	MD ‐0.07 units (‐0.27 units to 0.13 units)	501 (2 studies)	⊕⊕⊝⊝ low^1,2
Mean change in visual field score from baseline at 1‐year follow‐up	Not reported	Not reported	‐	‐	‐
Mean number of antiglaucoma medications at 1‐year follow‐up	The mean number of antiglaucoma medications ranged across Baerveldt implant groups from 1.2 to 1.5.	The mean number of antiglaucoma medications in the Ahmed implant groups was 0.35 higher (0.11 to 0.59 higher).	MD 0.35 (0.11 to 0.59)	464 (2 studies)	⊕⊕⊕⊝ moderate¹
Proportion needing additional glaucoma surgery at 1‐year follow‐up	20 per 1000	56 per 1000 (21 to 153)	RR 2.77 (1.02 to 7.54)	514 (2 studies)	⊕⊕⊕⊝ moderate¹
Adverse events up to 1‐year follow‐up	See comment	See comment	‐	‐	‐	The 2 trials reported specific adverse events (e.g. flat anterior chamber, choroidal effusion, hyphema), but not overall number of adverse events.
Quality of life at 1‐year follow‐up	Not reported	Not reported	‐	‐	‐
The basis for the assumed risk* is the mean control group risk across studies. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% confidence interval). CI: confidence interval; IOP: intraocular pressure; MD: mean difference; RR: risk ratio
GRADE Working Group grades of evidence High certainty: Further research is very unlikely to change our confidence in the estimate of effect. Moderate certainty: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low certainty: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low certainty: We are very uncertain about the estimate.
¹Downgraded (‐1) for high or unclear risk of bias among included trials. ²Downgraded (‐1) for imprecision of results (wide confidence intervals).

Summary of findings 2. Ahmed implant versus Baerveldt implant

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Summary of findings 3. Ahmed implant versus Molteno implant

Ahmed implant compared with Molteno implant for glaucoma
Population: People with glaucoma Settings: Glaucoma surgery Intervention: Ahmed implant Comparison: Molteno implant (single‐plate)
Outcomes*	Illustrative comparative risks (95% CI)**		Relative effect (95% CI)	No. of participants (studies)	Certainty of the evidence (GRADE)	Comments
Outcomes*	Assumed risk: Molteno implant	Corresponding risk: Ahmed implant	Relative effect (95% CI)	No. of participants (studies)	Certainty of the evidence (GRADE)	Comments
Mean IOP at 1‐year follow‐up	The mean IOP in the Molteno implant group was 15.36 mmHg.	The mean IOP in the Ahmed implant group was 1.64 mmHg higher (0.85 mmHg to 2.43 mmHg higher).	MD 1.64 mmHg (0.85 mmHg to 2.43 mmHg)	57 (1 study)	⊕⊕⊝⊝ low^1,2
Mean logMAR visual acuity at 1‐year follow‐up	The mean logMAR visual acuity in the Molteno implant group was 0.7 units.	The mean logMAR visual acuity in the Ahmed implant group was 0.08 units higher (0.24 units lower to 0.40 units higher).	MD 0.08 units (‐0.24 units to 0.40 units)	57 (1 study)	⊕⊝⊝⊝ very low^1,2,3
Mean change in visual field score from baseline at 1‐year follow‐up	The mean deviation in Humphrey visual fields in the Molteno implant group was ‐19.49 dB.	The mean deviation in Humphrey visual fields in the Ahmed implant group was 0.18 dB lower (3.13 dB lower to 2.77 dB higher).	MD ‐0.18 dB (‐3.13 dB to 2.77 dB)	57 (1 study)	⊕⊝⊝⊝ very low^1,2,3
Mean number of antiglaucoma medications at 1‐year follow‐up	The mean number of antiglaucoma medications in the Molteno implant group was 1.41.	The mean number of antiglaucoma medications in the Ahmed implant group was 0.38 lower (1.03 lower to 0.27 higher).	MD ‐0.38 (‐1.03 to 0.27)	57 (1 study)	⊕⊕⊝⊝ low^1,2
Proportion needing additional glaucoma surgery at 1‐year follow‐up	Not reported	Not reported	‐	‐	‐
Adverse events up to 1‐year follow‐up	See comment	See comment	‐	‐	‐	The trial reported specific adverse events (e.g. flat anterior chamber, choroidal effusion, hyphema), but not overall number of adverse events.
Quality of life at 1‐year follow‐up	Not reported	Not reported	‐	‐	‐
The primary follow‐up time for this review was 1 year, however the trial comparing Ahmed versus Molteno implants reported data at 2 years only. The basis for the assumed risk* is the mean control group risk across studies. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% confidence interval). CI: confidence interval; IOP: intraocular pressure; MD: mean difference
GRADE Working Group grades of evidence High certainty: Further research is very unlikely to change our confidence in the estimate of effect. Moderate certainty: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low certainty: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low certainty: We are very uncertain about the estimate.
¹Downgraded (‐1) for high or unclear risk of bias among included trials. ²Downgraded (‐1) for indirectness (follow‐up time was 2 years). ³Downgraded (‐1) for imprecision (wide confidence intervals).

Summary of findings 3. Ahmed implant versus Molteno implant

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Summary of findings 4. Molteno implant versus Schocket shunt

Molteno implant compared with Schocket shunt for glaucoma
Population: People with glaucoma Settings: Glaucoma surgery Intervention: Molteno implant (double‐plate) Comparison: Schocket shunt
Outcomes*	Illustrative comparative risks (95% CI)**		Relative effect (95% CI)	No. of participants (studies)	Certainty of the evidence (GRADE)	Comments
Outcomes*	Assumed risk: Schocket shunt	Corresponding risk: Molteno implant	Relative effect (95% CI)	No. of participants (studies)	Certainty of the evidence (GRADE)	Comments
Mean IOP at 1‐year follow‐up	The mean IOP in the Schocket shunt group was 18.9 mmHg.	The mean IOP in the Molteno implant group was 2.50 mmHg lower (4.60 mmHg to 0.40 mmHg lower).	MD ‐2.50 mmHg (‐4.60 mmHg to ‐0.40 mmHg)	115 (1 study)	⊕⊕⊝⊝ low^1,2	Another trial reported mean IOP for 40 participants (19 in the Molteno group and 21 in the Schocket shunt group), but did not report the follow‐up time at which data were collected.
Mean logMAR visual acuity at 1‐year follow‐up	Not reported	Not reported	‐	‐	‐
Mean change in visual field score from baseline at 1‐year follow‐up	Not reported	Not reported	‐	‐	‐
Mean number of antiglaucoma medications at 1‐year follow‐up	See comment	See comment	‐	‐	‐	1 trial reported the number of antiglaucoma medications for 40 participants (19 in the Molteno group and 21 in the Schocket shunt group), but did not report the follow‐up time at which data were collected. Another trial did not report this outcome.
Proportion needing additional glaucoma surgery at 1‐year follow‐up	Not reported	Not reported	‐	‐	‐
Adverse events up to 1‐year follow‐up	See comment	See comment	‐	‐	‐	1 trial reported specific adverse events (e.g. flat anterior chamber, choroidal effusion, hyphema), but not overall number of adverse events. Another trial did not report adverse events.
Quality of life at 1‐year follow‐up	Not reported	Not reported	‐	‐	‐
The primary follow‐up time for this review was 1 year, however the trial comparing Molteno implant versus Schocket shunt reported data at 6 months only. The basis for the assumed risk* is the mean control group risk across studies. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% confidence interval). CI: confidence interval; IOP: intraocular pressure; MD: mean difference
GRADE Working Group grades of evidence High certainty: Further research is very unlikely to change our confidence in the estimate of effect. Moderate certainty: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low certainty: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low certainty: We are very uncertain about the estimate.
¹Downgraded (‐1) for high or unclear risk of bias among included trials. ²Downgraded (‐1) for indirectness (follow‐up time was 6 months).

Summary of findings 4. Molteno implant versus Schocket shunt

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Table 1. Interventions evaluated in trials included in this review

Author year	Comparison and population	Number of eyes per group experimental/control	Maximum follow‐up time point reported
Aqueous shunts compared with trabeculectomy with or without MMC (4 trials)
Wilson 2000	Ahmed implant versus trabeculectomy with or without MMC for primary open‐ or closed‐angle glaucoma	55/62	1 year (11 to 13 months)
Wilson 2003	Ahmed implant versus trabeculectomy with or without MMC for primary open‐ or closed‐angle glaucoma	59/64	4 years (50 to 52 months)
Pakravan 2007	Ahmed implant with MMC versus trabeculectomy with MMC for pediatric aphakic glaucoma	15/15	Not reported
TVT 2009	Baerveldt 350 mm² implant versus trabeculectomy with MMC for glaucoma with previous trabeculectomy or cataract surgery	107/105	5 years
Aqueous shunts compared with other aqueous shunts (5 trials)
ABC 2011	Ahmed implant versus 350 mm² Baerveldt implant for glaucoma	143/133	5 years
AVB 2011	Ahmed implant versus 350 mm² Baerveldt implant for glaucoma	124/114	3 years
Nassiri 2010	Ahmed implant versus single‐plate Molteno implant for glaucoma	46/46	2 years
Smith 1992	Double‐plate Molteno versus Schocket shunt for glaucoma	19/21	Not reported
Wilson 1992	Double‐plate Molteno versus Schocket shunt for glaucoma	65/53	6 months
Aqueous shunts compared with and without modification (18 trials)
Law 2016	Ahmed implant with early aqueous suppression versus Ahmed implant with standard medication regimen for glaucoma	26/26	2 years
Pakravan 2014	Ahmed implant with early aqueous suppression versus Ahmed implant with standard medication regimen for glaucoma	47/47	1 year
Desai 2013	Ahmed implant with intravitreal ranibizumab versus Ahmed implant alone for open‐angle glaucoma	6/5	6 months
Arcieri 2015	Ahmed implant with intravitreal bevacizumab versus Ahmed implant alone for neovascular glaucoma	20/20	2 years
Mahdy 2013	Ahmed implant with intravitreal bevacizumab and panretinal photocoagulation versus Ahmed implant with panretinal photocoagulation for neovascular glaucoma	20/20	18 months
Rojo‐Arnao 2011	Ahmed implant with subconjunctival bevacizumab versus Ahmed implant alone for glaucoma	7/6	3 months
Teixeira 2012	Ahmed implant with intravitreal triamcinolone versus Ahmed implant alone for neovascular glaucoma	22/27	1 year
Yuen 2011	Ahmed implant with topical dexamethasone versus Ahmed implant with topical ketorolac for glaucoma	15/13	12 weeks
Yazdani 2016	Ahmed implant with amniotic membrane versus Ahmed implant alone for glaucoma	20/23	1 year
Rho 2015	Ahmed implant with biodegradable collagen matrix versus Ahmed implant alone for glaucoma	22/21	6 months
Hwang 2004	Ahmed implant with pericardium versus Ahmed implant alone for glaucoma	10/10	6 months
Kee 2001	Ahmed implant with partial tube ligation versus Ahmed implant with no ligation for glaucoma	16/16	6 months
Parihar 2016	Pars plana Ahmed implant versus conventional Ahmed implant for glaucoma with penetrating keratoplasty	29/29	2 years
Gil‐Carrasco 2016	Ahmed implant model M4 versus Ahmed implant model S2 for neovascular glaucoma	21/21	1 year
Britt 1999	500 mm² Baerveldt implant versus 350 mm² Baerveldt implant for non‐neovascular glaucoma	52/55	5 years
Valimaki 1999	Single‐plate Molteno implant with oral corticosteroids versus single‐plate Molteno implant without oral corticosteroids for glaucoma	11/11	6 months
Heuer 1992	Double‐plate Molteno implant versus single‐plate Molteno implant for non‐neovascular glaucoma	66/66	Not reported
Gerber 1997	Pressure‐ridge Molteno implant versus standard Molteno implant with tube ligation for glaucoma	15/15	12 weeks
MMC: mitomycin C

Table 1. Interventions evaluated in trials included in this review

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Comparison 1. Aqueous shunts versus trabeculectomy for glaucoma

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Mean intraocular pressure Show forest plot	3		Mean Difference (IV, Random, 95% CI)	Subtotals only

1.1 At 6 months follow‐up	1	195	Mean Difference (IV, Random, 95% CI)	0.70 [‐0.75, 2.15]
1.2 At 1 year follow‐up	3	380	Mean Difference (IV, Random, 95% CI)	2.55 [‐0.78, 5.87]
1.3 At 3 years follow‐up	1	141	Mean Difference (IV, Random, 95% CI)	‐0.30 [‐2.27, 1.67]
1.4 At 4 years follow‐up	1	110	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
1.5 At 5 years follow‐up	1	124	Mean Difference (IV, Random, 95% CI)	1.80 [‐0.46, 4.06]
2 Intraocular pressure outcomes at 1 year follow‐up Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

2.1 Complete success	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.2 Qualified or complete success	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Intraocular pressure outcomes at 3 years follow‐up Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

3.1 Complete success	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.2 Qualified or complete success	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 Intraocular pressure outcomes at 5 years follow‐up Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

4.1 Complete success	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.2 Qualified or complete success	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5 Mean difference in logMAR visual acuity Show forest plot	3		Mean Difference (Random, 95% CI)	Subtotals only

5.1 At 1 year follow‐up	3	380	Mean Difference (Random, 95% CI)	0.12 [‐0.07, 0.31]
5.2 At 3 years follow‐up	1	157	Mean Difference (Random, 95% CI)	0.04 [‐0.17, 0.25]
5.3 At 4 years follow‐up	1	110	Mean Difference (Random, 95% CI)	‐0.88 [‐2.17, 0.41]
5.4 At 5 years follow‐up	1	143	Mean Difference (Random, 95% CI)	0.2 [‐0.08, 0.48]
6 Mean change in visual field Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

6.1 At 1 year follow‐up	2	196	Mean Difference (IV, Fixed, 95% CI)	‐0.25 [‐1.91, 1.40]
6.2 At 4 years follow‐up	1	110	Mean Difference (IV, Fixed, 95% CI)	‐5.02 [‐5.65, ‐4.39]
7 Mean antiglaucoma medications Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

7.1 At 6 months follow‐up	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.2 At 1 year follow‐up	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.3 At 3 years follow‐up	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.4 At 5 years follow‐up	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
8 Need for reoperation to control glaucoma progression Show forest plot	3		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

8.1 At 1 year follow‐up	2	329	Risk Ratio (M‐H, Fixed, 95% CI)	0.24 [0.04, 1.36]
8.2 At 3 years follow‐up	1	212	Risk Ratio (M‐H, Fixed, 95% CI)	0.49 [0.19, 1.26]
8.3 At 4 years follow‐up	1	123	Risk Ratio (M‐H, Fixed, 95% CI)	2.17 [0.41, 11.41]
8.4 At 5 years follow‐up	1	212	Risk Ratio (M‐H, Fixed, 95% CI)	0.44 [0.20, 0.96]
9 Complications at 1 year follow‐up Show forest plot	2		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

9.1 Total participants with complications	1	212	Risk Ratio (M‐H, Fixed, 95% CI)	0.59 [0.43, 0.81]
9.2 Flat anterior chamber	2	329	Risk Ratio (M‐H, Fixed, 95% CI)	1.05 [0.62, 1.79]
9.3 Choroidal effusion	2	329	Risk Ratio (M‐H, Fixed, 95% CI)	1.67 [0.89, 3.14]
9.4 Hyphema	1	117	Risk Ratio (M‐H, Fixed, 95% CI)	1.13 [0.45, 2.80]
9.5 Persistent corneal edema	1	212	Risk Ratio (M‐H, Fixed, 95% CI)	2.29 [0.61, 8.62]
9.6 Cystoid macular edema	1	212	Risk Ratio (M‐H, Fixed, 95% CI)	1.47 [0.25, 8.63]
9.7 Bleb leak	2	329	Risk Ratio (M‐H, Fixed, 95% CI)	0.19 [0.03, 1.06]
9.8 Encapsulated bleb	1	212	Risk Ratio (M‐H, Fixed, 95% CI)	0.33 [0.07, 1.58]
9.9 Endophthalmitis/blebitis	1	212	Risk Ratio (M‐H, Fixed, 95% CI)	0.33 [0.03, 3.09]
9.10 Chronic/recurrent iritis	1	212	Risk Ratio (M‐H, Fixed, 95% CI)	1.96 [0.18, 21.32]
9.11 Corneal ulcer	1	212	Risk Ratio (M‐H, Fixed, 95% CI)	0.33 [0.01, 7.94]
9.12 Infection	1	117	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9.13 Dysesthesia	1	212	Risk Ratio (M‐H, Fixed, 95% CI)	0.14 [0.02, 1.12]
9.14 Persistent diplopia	1	212	Risk Ratio (M‐H, Fixed, 95% CI)	10.80 [0.60, 192.83]
9.15 Hypotony	1	117	Risk Ratio (M‐H, Fixed, 95% CI)	1.13 [0.07, 17.60]
9.16 Hypotony maculopathy	1	212	Risk Ratio (M‐H, Fixed, 95% CI)	0.33 [0.03, 3.09]
9.17 Implant exposure	1	117	Risk Ratio (M‐H, Fixed, 95% CI)	5.63 [0.28, 114.68]
9.18 Tube misdirection	1	117	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9.19 Retinal detachment	1	212	Risk Ratio (M‐H, Fixed, 95% CI)	2.94 [0.12, 71.47]
9.20 Suprachoroidal hemorrhage	1	117	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10 Complications at 3 years follow‐up Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

10.1 Total participants with complications	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.2 Flat anterior chamber	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.3 Choroidal effusion	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.4 Persistent corneal edema	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.5 Cystoid macular edema	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.6 Bleb leak	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.7 Encapsulated bleb	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.8 Endophthalmitis/blebitis	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.9 Chronic/recurrent iritis	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.10 Corneal ulcer	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.11 Dysesthesia	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.12 Persistent diplopia	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.13 Hypotony maculopathy	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.14 Retinal detachment	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
11 Complications at 4 years follow‐up Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

11.1 Flat anterior chamber	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
11.2 Hyphema	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
11.3 Bleb leak	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
11.4 Endophthalmitis/blebitis	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
11.5 Corneal ulcer	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
11.6 Implant exposure	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
11.7 Tube misdirection	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
11.8 Suprachoroidal hemorrhage	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
12 Complications at 5 years follow‐up Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

12.1 Flat anterior chamber	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
12.2 Choroidal effusion	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
12.3 Persistent corneal edema	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
12.4 Cystoid macular edema	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
12.5 Bleb leak	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
12.6 Encapsulated bleb	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
12.7 Endophthalmitis/blebitis	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
12.8 Chronic/recurrent iritis	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
12.9 Corneal ulcer	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
12.10 Dysesthesia	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
12.11 Persistent diplopia	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
12.12 Hypotony maculopathy	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
12.13 Retinal detachment	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 1. Aqueous shunts versus trabeculectomy for glaucoma

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Comparison 2. Ahmed implant versus 350 mm2 Baerveldt implant for glaucoma

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Mean intraocular pressure Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

1.1 At 6 months follow‐up	2	494	Mean Difference (IV, Fixed, 95% CI)	1.31 [0.25, 2.36]
1.2 At 1 year follow‐up	2	464	Mean Difference (IV, Fixed, 95% CI)	2.60 [1.58, 3.62]
1.3 At 3 years follow‐up	2	397	Mean Difference (IV, Fixed, 95% CI)	1.24 [0.31, 2.18]
1.4 At 5 years follow‐up	1	174	Mean Difference (IV, Fixed, 95% CI)	2.0 [0.68, 3.32]
2 Mean logMAR visual acuity Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

2.1 At 1 year follow‐up	2	501	Mean Difference (IV, Fixed, 95% CI)	‐0.07 [‐0.27, 0.13]
2.2 At 3 years follow‐up	2	396	Mean Difference (IV, Fixed, 95% CI)	‐0.02 [‐0.25, 0.22]
2.3 At 5 years follow‐up	1	173	Mean Difference (IV, Fixed, 95% CI)	‐0.01 [‐0.39, 0.37]
3 Mean number of antiglaucoma medications Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

3.1 At 6 months follow‐up	2	494	Mean Difference (IV, Fixed, 95% CI)	0.50 [0.27, 0.73]
3.2 At 1 year follow‐up	2	464	Mean Difference (IV, Fixed, 95% CI)	0.35 [0.11, 0.59]
3.3 At 3 years follow‐up	2	397	Mean Difference (IV, Fixed, 95% CI)	0.60 [0.33, 0.87]
3.4 At 5 years follow‐up	1	174	Mean Difference (IV, Fixed, 95% CI)	0.40 [‐0.03, 0.83]
4 Need for reoperation to control glaucoma progression Show forest plot	2		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

4.1 At 1 year follow‐up	2	514	Risk Ratio (M‐H, Fixed, 95% CI)	2.77 [1.02, 7.54]
4.2 At 3 years follow‐up	2	514	Risk Ratio (M‐H, Fixed, 95% CI)	1.98 [1.08, 3.65]
4.3 At 5 years follow‐up	1	276	Risk Ratio (M‐H, Fixed, 95% CI)	2.67 [1.24, 5.77]
5 Complications at 1 year follow‐up Show forest plot	2		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

5.1 Shallow anterior chamber	2	514	Risk Ratio (M‐H, Fixed, 95% CI)	0.97 [0.67, 1.38]
5.2 Choroidal effusion	2	514	Risk Ratio (M‐H, Fixed, 95% CI)	1.13 [0.73, 1.76]
5.3 Iritis	2	514	Risk Ratio (M‐H, Fixed, 95% CI)	0.55 [0.25, 1.23]
5.4 Corneal edema	2	514	Risk Ratio (M‐H, Fixed, 95% CI)	0.46 [0.31, 0.69]
5.5 Encapsulated bleb	1	238	Risk Ratio (M‐H, Fixed, 95% CI)	4.29 [1.27, 14.54]
5.6 Tube obstruction	2	514	Risk Ratio (M‐H, Fixed, 95% CI)	0.36 [0.17, 0.77]
5.7 Tube malposition	1	238	Risk Ratio (M‐H, Fixed, 95% CI)	1.84 [0.34, 9.85]
5.8 Tube erosion	2	514	Risk Ratio (M‐H, Fixed, 95% CI)	2.77 [0.56, 13.61]
5.9 Motility disorder/diplopia	2	514	Risk Ratio (M‐H, Fixed, 95% CI)	1.39 [0.82, 2.37]
5.10 Hyphema	2	514	Risk Ratio (M‐H, Fixed, 95% CI)	0.59 [0.34, 1.01]
5.11 Hypotony maculopathy	1	276	Risk Ratio (M‐H, Fixed, 95% CI)	1.40 [0.40, 4.84]
5.12 Malignant glaucoma	1	238	Risk Ratio (M‐H, Fixed, 95% CI)	1.84 [0.17, 20.01]
5.13 Suprachoroidal hemorrhage	2	514	Risk Ratio (M‐H, Fixed, 95% CI)	0.15 [0.02, 1.27]
5.14 Retinal/choroidal detachment	2	514	Risk Ratio (M‐H, Fixed, 95% CI)	0.69 [0.16, 3.08]
5.15 Endophthalmitis/episcleritis	2	514	Risk Ratio (M‐H, Fixed, 95% CI)	0.69 [0.16, 3.09]
5.16 Cystoid macular edema	1	276	Risk Ratio (M‐H, Fixed, 95% CI)	1.71 [0.65, 4.48]
6 Complications at 3 years follow‐up Show forest plot	2		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

6.1 Shallow anterior chamber	2	514	Risk Ratio (M‐H, Fixed, 95% CI)	0.91 [0.64, 1.29]
6.2 Choroidal effusion	2	514	Risk Ratio (M‐H, Fixed, 95% CI)	1.13 [0.73, 1.76]
6.3 Iritis	2	514	Risk Ratio (M‐H, Fixed, 95% CI)	0.75 [0.37, 1.53]
6.4 Corneal edema	2	514	Risk Ratio (M‐H, Fixed, 95% CI)	0.62 [0.43, 0.88]
6.5 Encapsulated bleb	2	514	Risk Ratio (M‐H, Fixed, 95% CI)	4.08 [1.31, 12.72]
6.6 Tube obstruction	1	276	Risk Ratio (M‐H, Fixed, 95% CI)	0.21 [0.07, 0.59]
6.7 Tube erosion	1	276	Risk Ratio (M‐H, Fixed, 95% CI)	0.40 [0.11, 1.51]
6.8 Motility disorder/diplopia	2	514	Risk Ratio (M‐H, Fixed, 95% CI)	1.24 [0.76, 2.02]
6.9 Hyphema	2	514	Risk Ratio (M‐H, Fixed, 95% CI)	0.57 [0.33, 0.97]
6.10 Hypotony maculopathy	1	276	Risk Ratio (M‐H, Fixed, 95% CI)	1.40 [0.40, 4.84]
6.11 Malignant glaucoma	1	238	Risk Ratio (M‐H, Fixed, 95% CI)	0.92 [0.13, 6.42]
6.12 Suprachoroidal hemorrhage	2	514	Risk Ratio (M‐H, Fixed, 95% CI)	0.15 [0.02, 1.27]
6.13 Retinal/choroidal detachment	2	514	Risk Ratio (M‐H, Fixed, 95% CI)	0.56 [0.13, 2.30]
6.14 Endophthalmitis/episcleritis	2	514	Risk Ratio (M‐H, Fixed, 95% CI)	0.69 [0.16, 3.09]
6.15 Cystoid macular edema	1	276	Risk Ratio (M‐H, Fixed, 95% CI)	1.73 [0.71, 4.20]
7 Complications at 5 years follow‐up Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

7.1 Shallow anterior chamber	1	276	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.60, 1.44]
7.2 Choroidal effusion	1	276	Risk Ratio (M‐H, Fixed, 95% CI)	1.36 [0.74, 2.52]
7.3 Iritis	1	276	Risk Ratio (M‐H, Fixed, 95% CI)	1.09 [0.37, 3.15]
7.4 Corneal edema	1	276	Risk Ratio (M‐H, Fixed, 95% CI)	0.69 [0.48, 1.00]
7.5 Encapsulated bleb	1	276	Risk Ratio (M‐H, Fixed, 95% CI)	2.79 [0.11, 67.94]
7.6 Tube obstruction	1	276	Risk Ratio (M‐H, Fixed, 95% CI)	0.21 [0.07, 0.59]
7.7 Tube erosion	1	276	Risk Ratio (M‐H, Fixed, 95% CI)	0.53 [0.16, 1.77]
7.8 Motility disorder/diplopia	1	276	Risk Ratio (M‐H, Fixed, 95% CI)	1.11 [0.65, 1.88]
7.9 Hyphema	1	276	Risk Ratio (M‐H, Fixed, 95% CI)	0.56 [0.31, 1.01]
7.10 Hypotony maculopathy	1	276	Risk Ratio (M‐H, Fixed, 95% CI)	1.40 [0.40, 4.84]
7.11 Retinal/choroidal detachment	1	276	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.13, 6.51]
7.12 Endophthalmitis	1	276	Risk Ratio (M‐H, Fixed, 95% CI)	0.13 [0.01, 2.55]
7.13 Cystoid macular edema	1	276	Risk Ratio (M‐H, Fixed, 95% CI)	1.45 [0.65, 3.23]

Comparison 2. Ahmed implant versus 350 mm2 Baerveldt implant for glaucoma

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Comparison 3. Ahmed implant versus single‐plate Molteno implant for glaucoma

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Mean intraocular pressure at 2 years follow‐up Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

2 Intraocular pressure outcomes at 2 years follow‐up Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

2.1 Complete success	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.2 Qualified or complete success	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Mean logMAR visual acuity at 2 years follow‐up Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

4 Visual field mean deviation at 2 years follow‐up Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

5 Mean number of antiglaucoma medications at 2 years follow‐up Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

6 Complications at 2 years follow‐up Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

6.1 Hyphema >1mm	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.2 Wound dehiscence	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.3 Choroidal effusion	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.4 Choroidal maculopathy	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.5 Flat anterior chamber	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.6 Tube obstruction	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.7 Tenon cyst	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.8 Cataract formation	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 3. Ahmed implant versus single‐plate Molteno implant for glaucoma

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Comparison 4. Double‐plate Molteno implant versus Schocket shunt for glaucoma

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Mean intraocular pressure at 6 months follow‐up Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

2 Complications at 6 to 12 months follow‐up Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

2.1 Choroidal detachment with shallow anterior chamber	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.2 Tube obstruction	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.3 Chronic uveitis	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.4 Hyphema	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.5 Sterile endophthalmitis	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.6 Chronic hypotony	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.7 Suprachoroidal hemorrhage	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.8 Malignant glaucoma	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 4. Double‐plate Molteno implant versus Schocket shunt for glaucoma

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Comparison 5. Ahmed implant with early aqueous suppression versus Ahmed implant with standard medication regimen for glaucoma

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Mean intraocular pressure Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

1.1 At 6 months follow‐up	2	141	Mean Difference (IV, Fixed, 95% CI)	‐4.02 [‐5.51, ‐2.53]
1.2 At 1 year follow‐up	1	39	Mean Difference (IV, Fixed, 95% CI)	‐0.20 [‐3.45, 3.05]
2 Mean logMAR visual acuity Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

2.1 At 1 year follow‐up	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Mean antiglaucoma medications Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

3.1 At 6 months follow‐up	2	141	Mean Difference (IV, Fixed, 95% CI)	0.30 [‐0.02, 0.63]
3.2 At 1 year follow‐up	1	39	Mean Difference (IV, Fixed, 95% CI)	0.0 [‐0.56, 0.56]

Comparison 5. Ahmed implant with early aqueous suppression versus Ahmed implant with standard medication regimen for glaucoma

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Comparison 6. Ahmed implant with anti‐VEGF versus Ahmed implant alone for glaucoma

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Mean intraocular pressure Show forest plot	3		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

1.1 At 6 months follow‐up	3		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.2 At 1 year follow‐up	2		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Mean antiglaucoma medications Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

2.1 At 6 months follow‐up	2	44	Mean Difference (IV, Fixed, 95% CI)	0.00 [‐0.63, 0.64]
2.2 At 1 year follow‐up	1	30	Mean Difference (IV, Fixed, 95% CI)	0.03 [‐0.65, 0.71]

Comparison 6. Ahmed implant with anti‐VEGF versus Ahmed implant alone for glaucoma

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Comparison 7. Ahmed implant with intravitreal triamcinolone versus Ahmed implant alone for neovascular glaucoma

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Mean intraocular pressure at 1 year follow‐up Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

2 Complete success at 1 year follow‐up Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

3 Mean antiglaucoma medications at 1 year follow‐up Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

4 Complications at 1 year follow‐up Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

4.1 Loss of light perception	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.2 Phthisis bulbi	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.3 Corneal decompensation	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.4 Hemorrhagic choroidal detachment	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.5 Hyphema	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.6 Serous choroidal detachment	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.7 Tube obstruction	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.8 Aqueous misdirection	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 7. Ahmed implant with intravitreal triamcinolone versus Ahmed implant alone for neovascular glaucoma

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Comparison 8. Ahmed implant with shunt augmentation versus Ahmed implant without shunt augmentation for glaucoma

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Mean intraocular pressure Show forest plot	3		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

1.1 At 6 months follow‐up	3		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.2 At 1 year follow‐up	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Intraocular pressure outcomes at 6 months follow‐up Show forest plot	2		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

2.1 Complete success	2	63	Risk Ratio (M‐H, Fixed, 95% CI)	1.50 [0.88, 2.55]
2.2 Qualified or complete success	2	63	Risk Ratio (M‐H, Fixed, 95% CI)	1.02 [0.88, 1.19]
3 Intraocular pressure outcomes at 1 year follow‐up Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

3.1 Complete success	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.2 Qualified or complete success	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 Postoperative hypertensive phase Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

5 Mean antiglaucoma medications at 6 months follow‐up Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

6 Complications at 6 months follow‐up Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

6.1 Early hypotony	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.2 Hyphema	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.3 Choroidal effusion	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.4 Tube exposure	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.5 Endophthalmitis	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.6 Wound leak	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7 Complications at 1 year follow‐up Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

7.1 Hyphema	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.2 Choroidal effusion	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.3 Tube exposure	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.4 Tube obstruction	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.5 Malignant glaucoma	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 8. Ahmed implant with shunt augmentation versus Ahmed implant without shunt augmentation for glaucoma

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Comparison 9. Ahmed implant with partial tube ligation versus Ahmed implant with no ligation for glaucoma

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Mean intraocular pressure at 6 months follow‐up Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

2 Intraocular pressure outcomes at 6 months follow‐up Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

2.1 Complete success	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.2 Qualified or complete success	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Complications at 6 months follow‐up Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

3.1 Hyphema	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.2 Shallow anterior chamber	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.3 Hypotony	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.4 Choroidal effusion/detachment	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.5 Tube obstruction	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 9. Ahmed implant with partial tube ligation versus Ahmed implant with no ligation for glaucoma

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Comparison 10. Pars plana versus conventional Ahmed implant for glaucoma with penetrating keratoplasty

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Mean intraocular pressure at 2 years follow‐up Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

2 Intraocular pressure outcomes at 2 years follow‐up Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

2.1 Complete success	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.2 Qualified or complete success	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Visual acuity improvement of 2 lines or more on Snellen chart at 2 years follow‐up Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

4 Complications at 2 years follow‐up Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

4.1 Tube‐graft touch	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.2 Shallow anterior chamber	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.3 Choroidal detachment	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.4 Vitreous hemorrhage	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.5 Tube exposure	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.6 Hyphema	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 10. Pars plana versus conventional Ahmed implant for glaucoma with penetrating keratoplasty

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Comparison 11. Ahmed model M4 versus Ahmed model S2 for neovascular glaucoma

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Mean intraocular pressure at 1 year follow‐up Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

1.1 At 6 months follow‐up	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.2 At 1 year follow‐up	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Visual acuity between 20/20 and 20/100 at 1 year follow‐up Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

3 Complications 1 day after surgery Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

3.1 Total complications	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.2 Hyphema	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.3 Hyphema, tube obstruction	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.4 DC	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.5 Contact with the iris	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.6 Flat grade 1 chamber	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 11. Ahmed model M4 versus Ahmed model S2 for neovascular glaucoma

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Comparison 12. 500 mm2 Baerveldt implant versus 350 mm2 Baerveldt implant for non‐neovascular glaucoma

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Mean intraocular pressure Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

1.1 At 1 year follow‐up	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.2 At 3 years follow‐up	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.3 At 5 years follow‐up	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Intraocular pressure outcomes Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

2.1 At 6‐18 months follow‐up	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.2 At 5 years follow‐up	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Complications at 5 years follow‐up Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

3.1 Diplopia/strabismus	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.2 Anterior uveitis	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.3 Retinal detachment	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.4 Tube obstruction	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.5 Choroidal effusion/detachment	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 12. 500 mm2 Baerveldt implant versus 350 mm2 Baerveldt implant for non‐neovascular glaucoma

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Comparison 13. Single‐plate Molteno implant with oral corticosteroids versus single‐plate Molteno implant alone for glaucoma

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Mean intraocular pressure at 6 months follow‐up Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

2 Intraocular pressure outcomes at 6 months follow‐up Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

3 Visual acuity within 1 Snellen line or improved at 6 months follow‐up Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

4 Mean antiglaucoma medications at 6 months follow‐up Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

5 Need for reoperation to control glaucoma progression Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

6 Complications at 6 months follow‐up Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

6.1 Hyphema	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.2 Tube exposure	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.3 Choroidal detachment	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.4 Strabismus/motility disorder	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 13. Single‐plate Molteno implant with oral corticosteroids versus single‐plate Molteno implant alone for glaucoma

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