Vitrectomy With Internal Limiting Membrane Peeling And Gas Tamponade For Myopic Foveoschisis:A Meta-analysis

Introduction To evaluate the efficacy and safety of pars plana vitrectomy(PPV)with internal limiting membrane(ILM)peeling and gas tamponade for myopic foveoschisis.Methods Searches were conducted in Pubmed,Embase,Medline,Cochrane,CNKI and WanFang Data with the strategy of“((internal limiting membrane)OR ILM)AND(vitrectomy OR PPV OR(pars plana vitrectomy))AND(foveoschisis OR retinoschisis OR maculopathy)".Postoperative best-corrected visual acuity(BCVA)and central foveal thickness(CFT)were considered as major surgery outcomes.The extracted data were analyzed using Stata(12.0)and R 3.4.2 in a fixed or random-effects model with a 95%confidence interval(CI).Cases of complications were collected as secondary outcomes to roughly evaluate the surgery safety.Results Fifteen studies involving total 287 eyes were selected in this meta-analysis.Statistically postoperative BCVA was better than preoperative BCVA,with a mean difference of-0.40 logMAR(95%CI:-0.52,-0.27;P≤0.001).CFT decreased significantly with an average level of-369.39μm(95%CI:-456.55,-282.23;P≤0.001)postoperatively.The proportion of BCVA improvement and retina reattachment reached up to 77%and 90%respectively.The most frequent postoperative complication was cataract with 55.6%probability.Macular hole(2.7%)and retinal detachment(1.1%)seldom occurred.Conclusions The analyses imply that PPV with ILM peeling and gas tamponade is a useful and secure method to treat foveoschisis in high myopia.