A Meta-analysis of the efficacy of internal limiting membrane reversal tamponade and internal limiting membrane stripping for macular hole retinal detachment in the highly myopia eyes / 国际眼科杂志(Guoji Yanke Zazhi)

ABSTRACT

@#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.