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PARS PLANA VITRECTOMY WITH OR WITHOUT INTERNAL LIMITING MEMBRANE PEEL FOR MACULAR HOLE: A Systematic Review and Meta-Analysis.
Mihalache, Andrew; Huang, Ryan S; Patil, Nikhil S; Ahmed, Haleema; Popovic, Marko M; Kertes, Peter J; Muni, Rajeev H.
Afiliación
  • Mihalache A; Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
  • Huang RS; Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
  • Patil NS; Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
  • Ahmed H; Faculty of Science, York University, Toronto, Ontario, Canada.
  • Popovic MM; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.
  • Kertes PJ; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.
  • Muni RH; John and Liz Tory Eye Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada ; and.
Retina ; 44(3): 381-391, 2024 03 01.
Article en En | MEDLINE | ID: mdl-38166007
ABSTRACT

PURPOSE:

To compare the efficacy and safety of pars plana vitrectomy with and without internal limiting membrane (ILM) peeling for macular hole (MH).

METHODS:

A systematic literature search on Ovid MEDLINE, Embase, Cochrane Library, and Google Scholar was performed from January 2000 to 2023. The primary outcome was the final best-corrected visual acuity (BCVA). Secondary outcomes included MH closure rates and the need for repeat surgery. The authors performed a random-effects meta-analysis on Review Manager 5.4.

RESULTS:

Fourteen studies on 880 eyes were included. Pars plana vitrectomy with and without ILM peel achieved a similar final BCVA ( P = 0.66). However, pars plana vitrectomy without ILM peeling achieved a significantly better final BCVA in eyes with closed MHs (WMD = 0.05 logMAR, 95% CI, 0.01-0.10, P = 0.02). Pars plana vitrectomy with ILM peeling achieved a significantly higher primary MH closure rate (RR = 1.21, 95% CI, 1.04-1.42, P = 0.02) and lower incidence of MH reoperation (RR = 0.19, 95% CI, 0.11-0.33, P < 0.001). The final MH closure rate ( P = 0.12) and incidence of MH recurrence ( P = 0.25) were similar between groups.

CONCLUSION:

Pars plana vitrectomy with and without ILM peel achieved a similar final BCVA. However, pars plana vitrectomy without ILM peeling achieved a better final BCVA in eyes with closed MHs. ILM peeling achieved a greater primary MH closure rate and reduced need for reoperation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Perforaciones de la Retina / Membrana Basal / Vitrectomía / Agudeza Visual Tipo de estudio: Systematic_reviews Límite: Humans Idioma: En Revista: Retina Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Perforaciones de la Retina / Membrana Basal / Vitrectomía / Agudeza Visual Tipo de estudio: Systematic_reviews Límite: Humans Idioma: En Revista: Retina Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos