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@#AIM:To investigate the efficacy and safety of different fillers combined with vitrectomy and internal limiting membrane stripping in the treatment of idiopathic macular hole(IMH).<p>METHODS: This retrospective study included 117 patients(117 eyes)with IMH who were admitted to the department of ophthalmology in the hospital between July 2018 and March 2020. Both groups were treated with vitrectomy combined with internal limiting membrane stripping. Sixty-five patients(65 eyes)receiving air filling were included in the air group, while 52 cases(52 eyes)receiving C3F8 filling were included in the C3F8 group. Re-examination was performed before operation and at 1, 2, and 3mo after operation. The rate of hole closure, closed shape, visual acuity, central macular thickness(CRT), exterior limiting membrane(ELM)defect diameter, ellipsoid band defect diameter, intraocular pressure, and the incidence of postoperative complications at the last follow-up were counted. <p>RESULTS: The postoperative air absorption time of air group and C3F8 group was 8.55±2.17d and 25.74±7.41d, respectively(<i>P</i><0.05). The macular hole closure rates in air group and C3F8 group were 95.4% and 98.1%, respectively(<i>P</i>>0.05). There were no significant differences in the proportions of different shapes of closed holes between the two groups(<i>P</i>>0.05). Visual acuity of the two groups was significantly improved at 3mo after operation(<i>P</i><0.001). There were no significant differences in LogMAR visual acuity and visual acuity changes between air group and C3F8 group(<i>P</i>>0.05). The CRT was increased significantly after operation(<i>P</i><0.001), and the diameters of ELM defect and ellipsoid band defect were reduced(<i>P</i><0.001). There were no significant differences in above indicators between the two groups(<i>P</i>>0.05). There was no significant difference in intraocular pressure between the two groups before and after treatment(<i>P</i>>0.05). No serious complications were observed in the two groups. <p>CONCLUSION: Vitrectomy and internal limiting membrane stripping combined with air filling and C3F8 filling are effective and safe in the treatment of IMH. Clinically, the operation mode can be selected according to the actual situation.
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@#AIM: To evaluate the anatomical and visual recovery effects of vitrectomy(PPV)combined with inner limiting membrane(ILM)reversal tamponade or ILM stripping in the treatment of high myopia macular hole retinal detachment(MHRD).<p>METHODS:The literature was retrieved from China Knowledge Network(CNKI), VIP, Wanfang Database, PubMed, EMbase, Cochrane Library, European PMC, and Natural database. The search time was built until September 2018. The 6-month follow-up time was used to observe the macular hole closure, primary retinal detachment and BCVA. Meta-analysis was performed using Review 5.3 and Stata 15.1 software.<p>RESULTS: In this study, a comparative analysis of 266 eyes in 8 studies was included. Statistically, the effect of ILM reversal tamponade in the macular hole closure rate is better than ILM stripping, the difference was statistically significant(<i>RR</i>=2.05, 95% <i>CI</i> 1.69 to 2.49, <i>P</i><0.00001), there was no statistically significant difference in the efficacy of primary retinal detachment rate(<i>RR</i>=1.04, 95% <i>CI</i> 0.98 to 1.12, <i>P</i>=0.21), the BCVA of the two groups was significantly higher than that before surgery at 6mo after surgery, the difference was statistically significant(<i>RR</i>=0.44, 95% <i>CI</i> 0.33 to 0.55, <i>P</i><0.00001; <i>RR</i>=0.29, 95% <i>CI</i> 0.10 to 0.48, <i>P</i>=0.003). The results of the extent of BCVA improvement between the two groups are heterogeneous, and the conclusions may be unstable, and more reliable data are needed.<p>CONCLUSION: PPV+ ILM flap insertion is more effective in treating patients with high myopia macular hole retinal detachment.