Zhang Bowen, Dong Xingmei, Sun Yi
Surgical Department, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
Department of Pathology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou 510120, China.
Heliyon. 2023 Feb 25;9(3):e14079. doi: 10.1016/j.heliyon.2023.e14079. eCollection 2023 Mar.
To further evaluate the necessity of internal limiting membrane (ILM) peeling for patients with idiopathic epiretinal membrane (iERM).
We searched PubMed, Web of Science, Embase, Cochrane Library, and CNKI from their inception up to August 24, 2021. Eligible meta-analyses comparing iERM removal with and without ILM peeling were included. AMSTAR and GRADE classification was used to assess the methodological quality of each study and the quality for each outcome, respectively. The primary outcomes were best-corrected visual acuity (BCVA), central macular thickness (CMT), and recurrence.
10 meta-analyses were included. 75.9% of studies revealed no statistically significant difference in BCVA between the groups, while only 10.3% showed better BCVA favorable to additional ILM peeling. 54.2% reported no significant difference in CMT between the groups, followed by 41.7% showing thicker CMT due to additional ILM peeling. Compared to iERM removal alone, additional ILM peeling provided a lower recurrence rate in 66.7% of studies.
ILM peeling could significantly reduce recurrence rate, but not significantly improve the recovery of visual outcome or decrease the thickness of central macula.
进一步评估特发性视网膜前膜（iERM）患者进行内界膜（ILM）剥除的必要性。
我们检索了PubMed、科学网、Embase、Cochrane图书馆和中国知网，检索时间从各数据库建库至2021年8月24日。纳入比较有无ILM剥除的iERM切除术的合格荟萃分析。分别使用AMSTAR和GRADE分类法评估每项研究的方法学质量和每个结局的质量。主要结局为最佳矫正视力（BCVA）、中心黄斑厚度（CMT）和复发率。
纳入10项荟萃分析。75.9%的研究显示两组间BCVA无统计学显著差异，而只有10.3%的研究显示额外的ILM剥除对BCVA更有利。54.2%的研究报告两组间CMT无显著差异，其次41.7%的研究显示额外的ILM剥除导致CMT更厚。与单纯iERM切除术相比，66.7%的研究显示额外的ILM剥除复发率更低。
ILM剥除可显著降低复发率，但不能显著改善视力恢复或降低中心黄斑厚度。
