This meta-analysis aimed to compare and evaluate the morphological and functional outcomes between the inverted internal limiting membrane (ILM) flap and ILM insertion techniques in the treatment of large macular holes (MHs). The primary outcome measures were defined by the MH closure rate, preoperative and postoperative best-corrected visual acuity (BCVA), MH closure patterns, and external limiting membrane (ELM) and ellipsoid zone (EZ) recovery. Two randomised controlled trials and four retrospective cohort studies were included in this meta-analysis. The MH closure rate did not significantly differ between the two groups (p=0.93). There was also no significant difference between postoperative BCVA between the two groups at three months (p=0.20) and six months (p=0.51). ELM and EZ recovery were also similar between the two groups. There was no significant difference between the two groups for the U-shape (p=0.26), V-shape (p=0.65), and W-shape closure types (p=0.38). This study concluded that the MH closure rate and visual function outcomes were similar between the ILM flap and ILM insertion techniques in large MHs. However, based on forest plot, postoperative BCVA and outer retinal layer reconstruction tended to favour the ILM flap technique. The authors recommend further larger population studies to evaluate the superiority of the ILM flap to the ILM insertion technique.
Inverted internal limiting membrane flap vs internal limiting membrane insertion technique for large macular holes
Reviewed by Su Young
Inverted internal limiting membrane flap versus internal limiting membrane insertion technique for large macular holes: a meta-analysis.
