A meta-analysis of vitrectomy with or without internal limiting membrane peeling for macular hole retinal detachment in the highly myopic eyes.
BACKGROUND
To evaluate the anatomical and visual outcomes by par plana vitrectomy with or without internal limiting membrane (ILM) peeling in highly myopic eyes with macular hole retinal detachment (MHRD).


METHODS
MEDLINE (Ovid, PubMed) and EMBASE were used for data collection up to September 30, 2015. The parameters of anatomical success, macular hole closure and improved best corrected visual acuity (BCVA) at or beyond 6 months after operation were assessed as the primary outcome measurement. The meta-analysis was performed with the fixed-effects model.


RESULTS
Seven comparative analyses involving a total of 373 patients were included in the present meta-analysis. Statistically the pooled data showed significant relative risk (RR) in terms of primary reattachment between ILM peeling and non-peeling groups (RR, 1.19; 95 % CI, 1.04 to 1.36; P = 0.012). An effect favoring ILM peeling with regard to macular hole closure was also detected (RR, 1.71; 95 % CI, 1.20 to 2.43; P = 0.003). However, no statistically significant difference was found in the improved BCVA (logarithm of the minimum angle of resolution) at 6 months or more (95 % CI, -0.31 to 0.44; P = 0.738).


CONCLUSIONS
There is no proved benefit of postoperative visual improvement. However, the available evidences from this study suggested a superiority of ILM peeling over no peeling for myopic patients with MHRD.
Department of Ophthalmology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.|Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Xinxiao
X
Gao
Department of Ophthalmology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Jia
J
Guo
Department of Ophthalmology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Xin
X
Meng
Department of Ophthalmology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. drwangjun@yeah.net.
Jun
J
Wang
Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China. drpengxy@yeah.net.
Xiaoyan
X
Peng
Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.
Yasushi
Y
Ikuno
D019773:Epiretinal Membrane / Q000601:surgery*; D006801:Humans; D047728:Myopia, Degenerative / Q000150:complications* / Q000601:surgery; D017063:Outcome Assessment, Health Care; D012163:Retinal Detachment / Q000209:etiology / Q000601:surgery*; D012167:Retinal Perforations / Q000209:etiology / Q000601:surgery*; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*