The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China; Department of Ophthalmology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Ophthalmology, Ningbo Eye Hospital, Ningbo, China.
Ann Palliat Med. 2021 May;10(5):5474-5482. doi: 10.21037/apm-21-871.
To compare the therapeutic effects of vitrectomy (PPV) combined with the internal limiting membrane (ILM) flap coverage and PPV in combination with ILM peeling on the idiopathic large macular hole (MH), in order to better guide the treatment of large MH.
Searching was conducted within PubMed, Web of Science, Embase, CNKI, and Wanfang databases, and relevant pieces of literature between 2010 and 2020 published in English or Chinese were included.
A total of 11 studies including 667 patients and 667 affected eyes were included; the effective rate of hole closure between the 2 groups were compared in 11 studies. Results exhibited 94.4% (286/303 eyes) in the test group (PPV combined with ILM flap coverage) and 85.8% (313/364 eyes) in the control group (PPV combined with ILM peeling) were closed. MH closure rates in the test group was superior to the control group [odds ratio (OR) =3.36, 95% confidence interval (CI): 1.88-6.01, P<0.001]. All 11 studies compared the preoperative and postoperative best corrected visual acuity (BCVA), with no significant difference in the preoperative test control group [standardized mean difference (SMD) =-0.18, 95% CI: -0.42 to 0.06, P=0.149]. The BCVA after surgery was better in the test group compared with the control group (SMD =-0.91, 95% CI: -1.43 to -0.40), P=0.001).
Compared with PPV combined with ILM peeling, PPV combined with ILM flap coverage can significantly improve the MH closure rate and postoperative BCVA.
比较玻璃体切割术（PPV）联合内界膜（ILM）瓣覆盖与 PPV 联合 ILM 剥除治疗特发性大黄斑孔（MH）的疗效，以更好地指导大 MH 的治疗。
在 PubMed、Web of Science、Embase、CNKI 和万方数据库中进行检索，纳入 2010 年至 2020 年发表的英文或中文相关文献。
共纳入 11 项研究，包括 667 例患者 667 只患眼；11 项研究比较了两组患者的孔闭合有效率。结果显示，试验组（PPV 联合 ILM 瓣覆盖）的孔闭合率为 94.4%（286/303 眼），对照组（PPV 联合 ILM 剥除）为 85.8%（313/364 眼）。试验组 MH 闭合率优于对照组[比值比（OR）=3.36，95%置信区间（CI）：1.88-6.01，P<0.001]。11 项研究均比较了术前和术后最佳矫正视力（BCVA），术前两组间差异无统计学意义[标准化均数差（SMD）=-0.18，95%CI：-0.42 至 0.06，P=0.149]。与对照组相比，试验组术后 BCVA 更好（SMD=-0.91，95%CI：-1.43 至-0.40），P=0.001）。
与 PPV 联合 ILM 剥除相比，PPV 联合 ILM 瓣覆盖可显著提高 MH 闭合率和术后 BCVA。
