Citation:Wu YJ,Rao J,Wu KR,Wu N,Cheng Y,Xu XX,Yan L,Shao Y,Tian Y,Wu XR.Vitrectomy with internal limiting membrane peeling versus its flap insertion for macular hole in high myopia: a Meta-analysis.Int J Ophthalmol 2020;13(1):141-148,doi:10.18240/ijo.2020.01.21
Vitrectomy with internal limiting membrane peeling versus its flap insertion for macular hole in high myopia: a Meta-analysis
Received:May 19, 2019  Revised:July 23, 2019
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DOI:10.18240/ijo.2020.01.21
Key Words:macular hole  high myopia  best-corrected visual acuity  retinal attachment  Meta-analysis
Fund Project:Supported by National Natural Science Foundation of China (No.81760179, No.81360151); Natural Science Foundation of Jiangxi Province (No.20171BAB205046); Key Foundation of Education Department of Jiangxi Province (No.GJJ160033); Health Development Planning Commission Science Foundation of Jiangxi Province (No.20185118); Foundation of Science and Technology Supported by Jiangxi Province (No.20141BBG70027); Chinese Medicine Research Project of Jiangxi Health and Family Planning Commission (No.2017A001); Jiangxi Province Grass-Roots Health Appropriate Technology Spark Promotion Project (No.20188007); Jiangxi Provincial Health and FP General Plan (No.20141031); General Project of Jiangxi Provincial Education Department (No.GJJ13147).
                             
AuthorInstitution
Ya-Jun Wu Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Nanchang , Jiangxi Province, China
Jie Rao Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Nanchang , Jiangxi Province, China
Kang-Rui Wu Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Nanchang , Jiangxi Province, China
Na Wu Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Nanchang , Jiangxi Province, China
Yi Cheng Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Nanchang , Jiangxi Province, China
Xiao-Xuan Xu Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Nanchang , Jiangxi Province, China
Li Yan Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Nanchang , Jiangxi Province, China
Yi Shao Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Nanchang , Jiangxi Province, China
Yu Tian Department of Ophthalmology, the Second Xiangya Hospital, Central South University, Changsha , Hunan Province, China
Xiao-Rong Wu Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Nanchang , Jiangxi Province, China
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Abstract:
      AIM: To compare the anatomic and functional outcomes between vitrectomy with internal limiting membrane (ILM) peeling and internal ILM flap insertion technique for high myopia macular hole (MH).

    METHODS: PubMed, Cochrane Library, EMBASE, and CNKI were systematically searched, and all studies involved MH were included. The closure rate of MH and the postoperative best-corrected visual acuity (BCVA) at 6mo after the initial surgery were the primary measures. All statistical tests were performed in Review Manager 5.3.

    RESULTS: Five studies that included 151 eyes of 151 patients were finally included, all of which were retrospectively comparative studies. Between the pars plana vitrectomy (PPV) with ILM peeling surgery and the ILM insertion technique, the latter had significantly better efficacy with respect to the closure rate of MH (OR=21.32, 95%CI=7.25-62.67, P<0.001); However, regarding BCVA at 6mo after the initial surgery in MH, there was no statistical significance between the groups (OR=-0.04, 95%CI=-0.22-0.14, P=0.66). In addition, regarding the rate of retinal reattachment after the initial surgery, the two different methods were not significantly different (OR=2.22, 95%CI=0.34-14.32, P=0.4).

    CONCLUSION: Both ILM peeling and ILM insertion technique could significantly improve anatomic outcomes of MH in high myopia with or without retinal detachment (RD), and anatomic outcomes are more effective. However, there is no statistical significance in BCVA at 6mo after the initial surgery in MH, or in the rate of retinal reattachment after the first surgery, between the two methods.

PMC FullText Html:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6942949/
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