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

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).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.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(RR=2.05, 95% CI 1.69 to 2.49, PRR=1.04, 95% CI 0.98 to 1.12, P=0.21), the BCVA of the two groups was significantly higher than that before surgery at 6mo after surgery, the difference was statistically significant(RR=0.44, 95% CI 0.33 to 0.55, PRR=0.29, 95% CI 0.10 to 0.48, P=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.CONCLUSION: PPV+ ILM flap insertion is more effective in treating patients with high myopia macular hole retinal detachment.

Keywords

• internal limiting membrane reversal tamponade
• internal limiting membrane stripping
• high myopia macular hole retinal detachment
• Meta-analysis