Embedding of lamellar hole-associated epiretinal proliferation combined with internal limiting membrane inversion for the treatment of lamellar macular hole: a case report

et al. 2020

BMC Ophthalmol

Background: Given the two different kinds of epiretinal membranes, this study aimed to compare both the structural and functional outcomes of lamellar macular holes with and without lamellar hole-associated epiretinal proliferation (LHEP) after surgery. Method: Publications up to July 2020 that compared the surgical outcomes of lamellar macular hole with and without LHEP were included. Forest plots were created by using a weighted summary of proportion meta-analysis. Fixed or random effects models were used on the basis of I2 heterogeneity estimates. Meanwhile, to evaluate the stability of the meta-analysis, a sensitivity analysis was carried out. Results: Eight pertinent publications that contained a total of 176 eyes without LHEP and 173 eyes with LHEP were included. They were all retrospective studies and had a follow-up of at least 6 months. In all studies, the preoperative best corrected visual acuity showed no significant differences between the two groups, and the visual acuity improved in both groups after surgery. The pooled result for the improved best corrected visual acuity was 0.18 (95% confidence interval (CI), 0.10 to 0.26; P < 0.01) between the with and without LHEP groups. The restored ellipsoid zone odds ratio was 0.80 (95% CI, 0.26 to 2.44; P = 0.69) for the group with LHEP compared to the group without LHEP. Conclusion: Patients without LHEP had better postoperative visual acuity than patients with LHEP. No significant difference in restored ellipsoid zone was found between the two groups.

Section: Discussionmentioning

confidence: 99%

Surgery outcomes of lamellar macular eyes with or without lamellar hole-associated epiretinal proliferation: a meta-analysis

et al. 2020

BMC Ophthalmol

“…Comparing with the regular surgery method, the main difference is about the disposition of ERM and ILM. Instead of peeling the membrane, in the new method, ERM was double inverted and ILM was apped [28,29]. This kind of surgery can retain LHEP and promote the recovery of LHM, and a study indicated that the development of LHEP might be a recovery progress of LMH [15].…”

Section: Discussionmentioning

confidence: 99%

Surgery Outcomes of Lamellar Macular Eyes with or without Lamellar Hole-Associated Epiretinal Proliferation: A Meta-Analysis

et al. 2020

Preprint

Background: To compare the visual outcomes and rate of restored ellipsoid zone (REZ) after surgery of lamellar macular hole (LMH) with and without lamellar hole-associated epiretinal proliferation (LHEP). Method: Publications up to November 2019 that compared the outcomes of LMH patients with and without LHEP who were managed by surgery were included. Forest plots were created using a weighted summary of proportion meta-analysis. A random effects mode was used and I2 heterogeneity estimates were calculated. Sensitivity analysis was carried out to evaluate the stability of the meta-analysis. Result: Eight pertinent publications studying a total of 176 eyes without LHEP and 173 eyes with LHEP were identified. They were all retrospective studies and had a mean follow-up of at least 6 months. In all studies, the best corrected visual acuity (BCVA) had no significant differences before surgery and improved in both groups, and in two studies the post-operative BCVA had no significant differences between two groups. The rate of REZ were different among studies included. Meta-analytic pooling of the improved BCVA between with and without LHEP groups was 0.18 (95 % CI, 0.10 to 0.26; P< 0.01), and the pooled data revealed an odd ratio of 0.80 (95% CI, 0.26 to 2.44; p = 0.69) in the rate of REZ, comparing the group without LHEP and the group with LHEP. In conclusion, patients without LHEP had better postoperative BCVA than patients with LHEP. No significant difference was found in REZ among the two groups.

“…Comparing these two surgical methods, the main difference exists in the disposition of ERM and ILM. Instead of peeling the membrane, in the new method, ERM is double inverted and ILM is apped [28,29]. This kind of surgery can retain LHEP and promote the recovery of LHM.…”

Section: Discussionmentioning

confidence: 99%

Surgery Outcomes of Lamellar Macular Eyes with or without Lamellar Hole-Associated Epiretinal Proliferation: A Meta-Analysis

et al. 2020

Preprint

Purpose: This study aimed at comparing both the structural and functional outcomes of lamellar macular hole (LMH) with and without lamellar hole-associated epiretinal proliferation (LHEP) after surgery. Method: Publications up to July 2020 that compared the surgical outcomes of LMH patients with and without LHEP were included. Forest plots were created using a weighted summary of proportion meta-analysis. Fixed or random effects modes were used based on I2 heterogeneity estimates. To evaluate the stability of the meta-analysis, sensitivity analysis was carried out. Result: Eight pertinent publications containing a total of 176 eyes without LHEP and 173 eyes with LHEP were included. They were all retrospective studies and had a mean follow-up of at least 6 months. In all studies, the preoperative best corrected visual acuity (BCVA) had no significant differences between the two groups and BCVA improved in both groups after surgery. Pooled results of the improved BCVA was 0.18 (95 % CI, 0.10 to 0.26; P< 0.01) between with and without LHEP groups. However, the odd ratio of restored ellipsoid zone was 0.80 (95% CI, 0.26 to 2.44; p = 0.69) among the group with LHEP and the group without LHEP. In conclusion, patients without LHEP had better postoperative BCVA than patients with LHEP. No significant difference was found in REZ among the two groups. The necessity of surgery for patients with LHEP needs more studies to identify.