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Fovea sparing versus complete internal limiting membrane peeling for myopic traction maculopathy: a meta-analysis

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Abstract

Purpose

Myopic traction maculopathy (MTM) is the leading cause of visual loss in high myopia. The purpose of this study was to compare the outcomes of pars plana vitrectomy (PPV) with fovea-sparing internal limiting membrane (ILM) peeling and complete ILM peeling for MTM.

Methods

A comprehensive literature search was performed to find relevant studies. A meta-analysis was conducted by comparing the weighted mean differences (WMD) in the change of best-corrected visual acuity (BCVA) and central foveal thickness (CFT) from baseline and calculating the odd ratios (OR) for rates of complete reattachment (CR) and postoperative macular hole (MH) formation.

Results

Ten studies were selected, including 417 eyes (172 eyes in the fovea-sparing ILM peeling group (FSIP) and 245 eyes in complete ILM peeling group (CIP)). There was no significant difference in terms of mean change in CFT from baseline and the rate of CR(WMD = 3.53, 95% CI, −25.56 to 32.63, P = 0.81, and OR = 1.41, 95% CI, 0.81 to 2.44, P = 0.22). FSIP was superior to CIP in terms of mean change of logMAR BCVA post operation (WMD = −0.09, 95% CI, −0.15 to −0.03, P = 0.003), and associated with a significantly lower frequency of postoperative MH formation (OR = 0.19, 95% CI, 0.07 to 0.50, P = 0.0008).

Conclusion

FSIP resulted in similar anatomic outcomes compared to CIP, but resulted in better visual acuity and lower rates of postoperative MH development.

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Data availability

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to thank Radouil Tzekov for his work as a voluntary copy editor of the manuscript.

Funding

Supported by the Science Research Foundation of Aier Eye Hospital Group (No.AM1901D3 and No.AR2001D1 to WS Li); Innovation Guidance Project of Science and Technology Department of Hunan Province (No.2018SK50102 to WS Li) and Welfare Technology Applied Research Program Fund of Science Technology Department of Zhejiang Province (No. LGF18H120002 to YH Tong).

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Authors and Affiliations

  1. Department of Ophthalmology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, Zhejiang, People’s Republic of China

    Guohai Chen, Sihong Mao, Yuhua Tong & Fangzheng Jiang

  2. Shanghai Aier Eye Hospital, 1286 Hongqiao Road, Shanghai, People’s Republic of China

    Jiasong Yang & Wensheng Li

  3. Aier School of Ophthalmology, Central South University, Changsha, Hunan, People’s Republic of China

    Jiasong Yang & Wensheng Li

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Contributions

GHC, SHM, and WSL conceived and designed the study; acquisition of data was done by GHC, YHT, and FZJ; analysis and interpretation of data were done by GHC, SHM, and JSY; drafting the manuscript was done by GHC, SHM, and YHT; revising the manuscript critically for important intellectual content was done by WSL. All authors read and approved the final manuscript.

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Correspondence to Wensheng Li.

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Chen, G., Mao, S., Tong, Y. et al. Fovea sparing versus complete internal limiting membrane peeling for myopic traction maculopathy: a meta-analysis. Int Ophthalmol 42, 765–773 (2022). https://doi.org/10.1007/s10792-021-02042-2

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