With or without internal limiting membrane peeling during idiopathic epiretinal membrane surgery: A meta-analysis
PLOS ONE , Volume 16; doi:10.1371/journal.pone.0245459
Abstract: Background Although previously published meta-analyses have compared the surgical effects between the methods of Idiopathic epiretinal membrane (iERM) removal with or without ILM peeling, they did not reach an agreement. Purpose We aimed to provide more evidence for the treatment of iERM and whether additional ILM peeling was better or not by analyzing more updated studies and randomized control trials (RCTs). Method The search was conducted in Pubmed, Embase, Cochrane Library, Web of Science and Open Grey without language limitation and the studies included were from inception to December 2019. All studies of iERM with or without ILM peeling showed at least one of outcomes, such as best-corrected visual acuity (BCVA), central macular thickness (CMT) and recurrence of ERM. The pooled results between above groups were showed by the mean differences (MDs) and risk ratios (RR) with corresponding 95% confidence intervals (CIs). Result In total, 1645 eyes of five randomized controlled trials (RCTs) and fifteen retrospective studies were included. The short-term ( Conclusion By considering the risk of bias, we should determine whether ILM peeling is beneficial for short-term changes in BCVA in patients with iERM. Nevertheless, further studies are needed to confirm this. iERM removal without ILM peeling can improve the short-term decrease in CMT and ILM peeling decreases the recurrence of ERM, but the long-term changes in BCVA and CMT are similar with or without ILM peeling. There is a need for a true large scale randomized trial that will also include microperimetry and other functional measures.
Keywords: Surgical and invasive medical procedures / retina / eyes / randomized controlled trials / MetaAnalysis / visual acuity / Retrospective studies / Medical Risk Factors
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