Vitrectomy with fovea-sparing ILM peeling versus total ILM peeling for myopic traction maculopathy: A meta-analysis.

Abstract

To evaluate the effect and safety of fovea-sparing internal limiting membrane (ILM) peeling (FSIP) for myopic traction maculopathy comparing with that of total ILM peeling (TP). PubMed, Web of science, Embase, Cochrane, EBSCO and CNKI, published until January 2020, were searched. Postoperative best-corrected visual acuity (BCVA), postoperative central foveal thickness (CFT), the rate of visual improvement and anatomic success were the main outcome parameters, and the secondary outcome parameters were postoperative complications. Random-effects models were chosen in regard with multi-studies. Standard mean difference (SMD) with 95% confidence interval (CI) and odds ratio (OR) were applied as effect sizes of continuous and binomial data, respectively. Six comparative studies involving 193 eyes were included. Better postoperative BCVA was detected in the FSIP group (SMD = -0.39, 95%CI: -0.69 to -0.09, p = 0.01). The FSIP group had a higher rate of vision improvement with statistical significance (OR = 3.86, 95%CI: 1.36 to 10.97, p = 0.01). Both surgical methods had similar outcomes for postoperative CFT (SMD = 0.07, 95%CI: -0.27 to 0.40, p = 0.70). The FSIP group had a higher rate of anatomic success, though there was no obvious significance (OR = 2.54, 95%CI: 0.96 to 6.74, p = 0.06). For the development of postoperative full-thickness macular hole (FTMH), the rate was lower in the FSIP group (OR = 0.18, 95%CI: 0.05 to 0.64, p = 0.008). Vitrectomy with fovea-sparing ILM peeling for myopic traction maculopathy could gain better visual outcomes and decrease incidence of FTMH development, though there was no obvious difference in postoperative CFT and the rate of anatomic success between two groups.