Christodoulou Eleni, Batsos Georgios, Galanis Petros, Kalogeropoulos Christos, Katsanos Andreas, Alamanos Yannis, Stefaniotou Maria
Department of Ophthalmology, University of Ioannina, Ioannina, Greece.
Center for Health Services Management and Evaluation, Department of Nursing, National and Kapodistrian University of Athens, Athens, Greece.
Ther Adv Ophthalmol. 2020 Aug 20;12:2515841420927133. doi: 10.1177/2515841420927133. eCollection 2020 Jan-Dec.
The aim of this study is to analyze the effect of internal limiting membrane peeling in removal of idiopathic epiretinal membranes through meta-analysis.
We searched PubMed for studies published until 30 April 2018. Inclusion criteria included cases of idiopathic epiretinal membranes, treated with vitrectomy with or without internal limiting membrane peeling. Exclusion criteria consisted of coexisting retinal pathologies and use of indocyanine green to stain the internal limiting membrane. Sixteen studies were included in our meta-analysis. We compared the results of surgical removal of epiretinal membrane, with or without internal limiting membrane peeling, in terms of best-corrected visual acuity and anatomical restoration of the macula (central foveal thickness). Studies or subgroups of patients who had indocyanine green used as an internal limiting membrane stain were excluded from the study, due to evidence of its toxicity to the retina.
Regarding best-corrected visual acuity levels, the overall mean difference was -0.29 (95% confidence interval: -0.319 to -0.261), while for patients with internal limiting membrane peeling was -0.289 (95% confidence interval: -0.334 to -0.244) and for patients without internal limiting membrane peeling was -0.282 (95% confidence interval: -0.34 to -0.225). Regarding central foveal thickness levels, the overall mean difference was -117.22 (95% confidence interval: -136.70 to -97.74), while for patients with internal limiting membrane peeling was -121.08 (95% confidence interval: -151.12 to -91.03) and for patients without internal limiting membrane peeling was -105.34 (95% confidence interval: -119.47 to -96.21).
Vitrectomy for the removal of epiretinal membrane combined with internal limiting membrane peeling is an effective method for the treatment of patients with idiopathic epiretinal membrane.
本研究旨在通过荟萃分析，分析内界膜剥除术在去除特发性视网膜前膜中的作用。
我们在PubMed上检索截至2018年4月30日发表的研究。纳入标准包括特发性视网膜前膜病例，接受有或无内界膜剥除术的玻璃体切除术治疗。排除标准包括并存的视网膜病变以及使用吲哚菁绿对内界膜进行染色。16项研究纳入我们的荟萃分析。我们比较了有或无内界膜剥除术的视网膜前膜手术切除结果，涉及最佳矫正视力和黄斑（中心凹厚度）的解剖学恢复情况。由于有证据表明吲哚菁绿对视网膜有毒性，将使用吲哚菁绿作为内界膜染色剂的研究或患者亚组排除在研究之外。
关于最佳矫正视力水平，总体平均差异为-0.29（95%置信区间：-0.319至-0.261），内界膜剥除术患者为-0.289（95%置信区间：-0.334至-0.244），无内界膜剥除术患者为-0.282（95%置信区间：-0.34至-0.225）。关于中心凹厚度水平，总体平均差异为-117.22（95%置信区间：-136.70至-97.74），内界膜剥除术患者为-121.08（95%置信区间：-151.12至-91.03），无内界膜剥除术患者为-105.34（95%置信区间：-119.47至-96.21）。
玻璃体切除术联合内界膜剥除术治疗特发性视网膜前膜患者是一种有效的方法。
