Ophthalmic Surg Lasers Imaging Retina. 2020 Mar 1;51(3):187-A2. doi: 10.3928/23258160-20200228-08.
To compare complete internal limiting membrane (ILM) peeling with the inverted flap technique for macular hole (MH) surgery.
An electronic database search on PubMed, CENTRAL, and ClinicalTrials.gov was performed. Inclusion criteria were comparative prospective/retrospective studies including patients with MH of any size with at least 6 months of follow-up. The primary outcome was MH closure rate. Secondary outcomes were best-corrected visual acuity improvement and surgery-related adverse events.
Sixteen papers enrolling 1,403 eyes were included (733 ILM peeling, 670 inverted flap). MH mean minimum diameter and time of symptomatic evolution were higher in the inverted flap group (531.1 μm ± 188.8 μm vs. 602.8 μm ± 223.8 μm; 10.4 ± 20.2 months vs. 12.0 ± 18.4 months; P < .01). Overall, MH closure rate was superior with the inverted flap technique (risk-ratio [RR]: 1.25; 95% confidence interval [CI], 1.14-1.38; P < .0001), as well as in all subgroups: idiopathic large MH (n = 362; RR: 1.12; 95% CI, 1.05-1.20; P < .001), myopic MH without retinal detachment (n = 133; RR: 1.35; 95% CI, 1.14-1.59; P < .001), and MH retinal detachment (n = 198; RR: 1.89; 95% CI, 1.31-2.73; P < .001).
This meta-analysis suggests the inverted flap technique is more effective in achieving MH closure. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:187-195.].
比较完全内界膜（ILM）剥离与翻转瓣技术治疗黄斑裂孔（MH）。
在 PubMed、CENTRAL 和 ClinicalTrials.gov 上进行电子数据库检索。纳入标准为包括任何大小的 MH 患者的前瞻性/回顾性比较研究，随访时间至少 6 个月。主要结局是 MH 闭合率。次要结局是最佳矫正视力改善和手术相关不良事件。
纳入了 16 篇论文，共 1403 只眼（733 例 ILM 剥离，670 例翻转瓣）。翻转瓣组 MH 平均最小直径和症状出现时间较高（531.1μm±188.8μm比 602.8μm±223.8μm；10.4±20.2 个月比 12.0±18.4 个月；P<.01）。总体而言，翻转瓣技术的 MH 闭合率更高（风险比[RR]：1.25；95%置信区间[CI]：1.14-1.38；P<.0001），并且在所有亚组中也是如此：特发性大 MH（n=362；RR：1.12；95% CI：1.05-1.20；P<.001）、无视网膜脱离的近视性 MH（n=133；RR：1.35；95% CI：1.14-1.59；P<.001）和 MH 视网膜脱离（n=198；RR：1.89；95% CI：1.31-2.73；P<.001）。
这项荟萃分析表明，翻转瓣技术在 MH 闭合方面更有效。[眼科手术激光成像视网膜。2020；51：187-195。]。
