Novel surgical approaches for treating myopic traction maculopathy: a meta-analysis.

Autor: Quiroz-Reyes MA; Oftalmologia Integral ABC, Retina Department, Medical and Surgical Assistance Institution (Nonprofit Organization) affiliated with the Postgraduate Studies Division at the National Autonomous University of Mexico, Lomas de Chapultepec, Lomas de Chapultepec, Mexico City, 11000, Mexico. drquiroz@prodigy.net.mx., Quiroz-Gonzalez EA; Oftalmologia Integral ABC, Retina Department, Medical and Surgical Assistance Institution (Nonprofit Organization) affiliated with the Postgraduate Studies Division at the National Autonomous University of Mexico, Lomas de Chapultepec, Lomas de Chapultepec, Mexico City, 11000, Mexico.; Institute of Ophthalmology, Chimalpopoca 14, 06800, Mexico City, Colonia Obrera, Mexico., Quiroz-Gonzalez MA; Oftalmologia Integral ABC, Retina Department, Medical and Surgical Assistance Institution (Nonprofit Organization) affiliated with the Postgraduate Studies Division at the National Autonomous University of Mexico, Lomas de Chapultepec, Lomas de Chapultepec, Mexico City, 11000, Mexico., Lima-Gomez V; Juarez Hospital, Colonia Magdalena de Las Salinas, Av. Politecnico Nacional 5160, 07760, Mexico City, Mexico.
Jazyk: angličtina
Zdroj: BMC ophthalmology [BMC Ophthalmol] 2024 Mar 05; Vol. 24 (1), pp. 105. Date of Electronic Publication: 2024 Mar 05.
DOI: 10.1186/s12886-024-03374-0
Abstrakt: Background: Myopic traction maculopathy (MTM) is a complication of pathological myopia and encompasses various pathological conditions caused by tractional changes in the eye. These changes include retinoschisis, foveal retinal detachment, and lamellar or full-thickness macular holes (FTMHs). This meta-analysis evaluated the safety and efficacy of novel surgical for treating MTM.
Methods: To compare the outcomes of different surgical approaches for MTM, multiple databases, including Web of Science, PubMed, Scopus, ClinicalTrials.gov, the Cochrane Central Register of Controlled Trials, Ovid MEDLINE, Embase, and the Meta-Register of Controlled Trials, were comprehensively searched. The meta-analysis was performed using RevMan 5.1.
Results: Nine comparative studies involving 350 eyes were included in this meta-analysis. There were significant differences between fovea-sparing internal limiting membrane peeling (FSIP) and standard internal limiting membrane peeling (ILMP). Preoperative best-corrected visual acuity BCVA (standard mean difference (SMD): -0.10, 95% CI: -0.32 to 0.12) and central foveal thickness CFT (SMD: 0.05, 95% CI: -0.22 to 0.33) were not significantly different (p = 0.39 and p = 0.71, respectively). However, the postoperative BCVA improved significantly (SMD = - 0.47, 95% CI: - 0.80, - 0.14, p = 0.006) in the FSIP group compared to the standard ILMP group. Postoperative CFT did not differ significantly between the two groups (p = 0.62). The FSIP group had a greater anatomical success rate than the other groups, although the difference was not statistically significant (p = 0.26). The incidence of postoperative macular hole formation was significantly lower (OR = 0.19, 95% CI = 0.07-0.54; p = 0.05) in the FSIP group than in the standard ILMP group. The unique characteristics of highly myopic eyes, such as increased axial length and structural changes, may have contributed to the greater incidence of FTMH in the ILMP group.
Conclusion: Based on the findings of this meta-analysis, FSIP is the initial surgical approach for early-stage MTM and has shown promising outcomes. However, to establish the safest and most efficient surgical technique for treating different MTM stages, further comparative studies, specifically those focusing on ILMP and FSIP, are necessary.
Trial Registration: Retrospectively registered.
(© 2024. The Author(s).)
Databáze: MEDLINE
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