SURGICAL OUTCOMES OF LAMELLAR MACULAR HOLE EYES WITH OR WITHOUT PRESERVATION OF LAMELLAR HOLE-ASSOCIATED EPIRETINAL PROLIFERATION TECHNIQUE: A Meta-analysis.

Abstract

To evaluate sparing or embedding technique for lamellar hole-associated epiretinal proliferation and in comparison with traditional internal limiting membrane and epiretinal membrane peeling in lamellar macular holes. PubMed, Web of Science, Medline, EMBASE, Cochrane, CNKI, Wan Fang, and VIP Databases (PROSPERO number CRD42024466392) were searched. Trials of various lamellar hole-associated epiretinal proliferation removal or preservation techniques in lamellar macular holes were included (case reports of only 1 case excluded). Postoperative changes in best-corrected visual acuity were calculated. Central retinal thickness and number of patients with new postoperative intact ellipsoid zones were secondary outcomes. Eight studies were eligible and four compared with peeling groups. Preservation groups showed a significant visual improvement operatively (mean difference = -0.25 logMAR; 95% confidence interval = -0.30 to -0.21; P < 0.00001) and improved compared with peeling groups (mean difference = -0.19 logMAR; 95% confidence interval = -0.29 to -0.1; P < 0.0001). In addition, the number of patients with intact ellipsoid zones increased in the preserving groups (odd ratio = 2.55; 95% confidence interval = 1.48-4.38; P = 0.0007) and also increased compared with peeling groups (odd ratio =10.80; 95% confidence interval = 1.86-62.83; P = 0.008). Based on the current evidence, lamellar hole-associated epiretinal proliferation sparing or embedding technique has favorable postoperative outcomes compared with peeling technique for lamellar macular holes.