Long-term outcome of internal limiting membrane peeling with and without foveal sparing in myopic foveoschisis

Elwan, Mohamed; Elghafar, Ayman Elsayed Abd; Hagras, Sherein M; Samra, Waleed Abou; Saleh, Sameh

doi:10.1177/1120672117750059

Cited by 14 publications

(23 citation statements)

References 26 publications

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“…By screening titles and abstracts, 20 studies were excluded. Finally, six studies [16][17][18][19][20]23 in English were eligible for this meta-analysis by assessing full text (Figure 1). Non-randomized and retrospective studies were included.…”

Section: Search Resultsmentioning

confidence: 99%

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Vitrectomy with fovea-sparing ILM peeling versus total ILM peeling for myopic traction maculopathy: A meta-analysis

Luan

2020

European Journal of Ophthalmology

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Purpose: To evaluate the effect and safety of fovea-sparing internal limiting membrane (ILM) peeling (FSIP) for myopic traction maculopathy comparing with that of total ILM peeling (TP). Methods: PubMed, Web of science, Embase, Cochrane, EBSCO and CNKI, published until January 2020, were searched. Postoperative best-corrected visual acuity (BCVA), postoperative central foveal thickness (CFT), the rate of visual improvement and anatomic success were the main outcome parameters, and the secondary outcome parameters were postoperative complications. Random-effects models were chosen in regard with multi-studies. Standard mean difference (SMD) with 95% confidence interval (CI) and odds ratio (OR) were applied as effect sizes of continuous and binomial data, respectively. Results: Six comparative studies involving 193 eyes were included. Better postoperative BCVA was detected in the FSIP group (SMD = −0.39, 95%CI: −0.69 to −0.09, p = 0.01). The FSIP group had a higher rate of vision improvement with statistical significance (OR = 3.86, 95%CI: 1.36 to 10.97, p = 0.01). Both surgical methods had similar outcomes for postoperative CFT (SMD = 0.07, 95%CI: −0.27 to 0.40, p = 0.70). The FSIP group had a higher rate of anatomic success, though there was no obvious significance (OR = 2.54, 95%CI: 0.96 to 6.74, p = 0.06). For the development of postoperative full-thickness macular hole (FTMH), the rate was lower in the FSIP group (OR = 0.18, 95%CI: 0.05 to 0.64, p = 0.008). Conclusion: Vitrectomy with fovea-sparing ILM peeling for myopic traction maculopathy could gain better visual outcomes and decrease incidence of FTMH development, though there was no obvious difference in postoperative CFT and the rate of anatomic success between two groups.

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Section: Search Resultsmentioning

confidence: 99%

“…In recent years, there are several studies focusing on this technique. Elwan et al 17 found no superiority of fovea-sparing ILM peeling. Given that the sample sizes were small, the pooled data would contribute to more reliable outcomes.…”

Section: Introductionmentioning

confidence: 98%

Vitrectomy with fovea-sparing ILM peeling versus total ILM peeling for myopic traction maculopathy: A meta-analysis

Luan

2020

European Journal of Ophthalmology

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“…Such adverse events may be even more common in pathological myopia, characterized by long axial length and diffuse chorioretinal atrophy. To prevent postoperative macular hole formation and possible damage to the fovea, a fovea-sparing ILMP technique has been advocated [8,19,20], but some studies have shown that there is no difference in postoperative visual acuity between fovea-sparing ILMP and complete ILMP [9,10].…”

Section: Discussionmentioning

confidence: 99%

“…Many subsequent studies have demonstrated that vitrectomy with internal limiting membrane peeling (ILMP) can be effective in producing both anatomical and functional improvement in MF [3][4][5][6][7]. In order to reduce postoperative macular hole (MH) formation and foveal damage, a partial ILMP technique with foveal sparing was proposed [8], but there is little evidence that this technique has better outcomes than complete ILMP [9,10] Furthermore, more recent studies have shown similar anatomical and functional improvements can be achieved without any form of IMLP [4,11], casting doubt on the benefits of ILMP.…”

Section: Introductionmentioning

confidence: 99%

Vitrectomy with or without internal limiting membrane peeling for myopic foveoschisis

Gui¹,

Ai²,

Huang³

2020

BMC Ophthalmol

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Background: The aim of this study was to compare the anatomical and visual outcomes of vitrectomy with or without internal limiting membrane (ILM) peeling for symptomatic myopic foveoschisis (MF). Methods: A retrospective cohort study of patients who had undergone vitrectomy for symptomatic MF at our specialist ophthalmology department in China. Cases were retrospectively categorized into one of two cohorts, depending on whether or not they had undergone ILM peeling (ILMP) during their surgery. Over a mean follow-up period of 18 months, all eyes underwent repeated examinations, including best-corrected visual acuity (BCVA) and optical coherence tomographic (OCT) recordings, particularly focusing on central foveal thickness (CFT), macular hole (MH) formation and/or foveal detachment (FD). Results: We included 32 eyes (32 patients) with mean age of 62.2 ± 7.4 years. 31 patients (96.8%) were female. There were 21 eyes in the ILMP cohort and 11 eyes in the non-ILMP cohort. There were no significant preoperative differences in age, axial length, symptom duration or postoperative follow-up period between the two cohorts. MF was resolved completely in all of the eyes except one eye in the ILMP cohort. The postoperative CFT was significantly reduced compared to the preoperative baseline in both cohorts (469 ± 203 μm to 253 ± 56 μm; p = 0.003 in no-ILMP; 495 ± 178 μm to 244 ± 63 μm; p < 0.001 in ILMP, respectively). The final BCVA improved significantly in non-ILMP (1.27 ± 0.63 logMAR to 0.73 ± 0.55 logMAR; p = 0.021); but not significantly in ILMP cohort (1.25 ± 0.51 to 0.98 ± 0.57 logMAR; p = 0.143). Conclusion: Vitrectomy, either with or without ILM peeling, results in a significant anatomical improvement in eyes with MF. Eyes treated by vitrectomy may have a better visual improvement when ILM was not peeled.

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“…Numerous surgical options for the treatment of foveoschisis have been reported (27). A number of studies have suggested the benefits of vitrectomy for the resolution of foveoschisis by removing vitreoretinal traction (28,29). However, the evidence supporting the need to peel the ILM is inconsistent.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of 23G vitrectomy and internal limiting membrane peeling with brilliant blue in patients with myopic foveoschisis from a retrospective cohort study

2019

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The aim of the present study was to investigate whether internal limiting membrane (ILM) peeling in patients with myopic foveoschisis (MF) treated with 23-gauge (23G) vitrectomy improved the anatomical and visual outcomes. In this retrospective cohort study, from March 2014 to August 2017 at the Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University (Nanchang, China), 60 patients (60 eyes) with MF underwent 23G vitrectomy. The patients were grouped according to whether they underwent brilliant blue-assisted ILM peeling (peeling group) or not (non-peeling group). Best-corrected visual acuity (BCVA) and central macular thickness (CMT) on optical coherence tomography were measured. There were 30 eyes in each group and the baseline characteristics were similar (all P>0.05). BCVA improved in 24 eyes (80%) in the peeling group and 25 eyes (83.3%) in the non-peeling group (P=0.922). Preoperative CMT was not significantly different between the peeling and non-peeling group (458±62.2 vs. 460±61.1 µm, respectively, P=0.229). However, postoperative CMT was significantly different between the peeling and non-peeling group (269.3±67.7 vs. 294.4±60.5 µm, respectively; P=0.015). In the peeling group, MF was completely resolved in all 30 eyes, but only in 26 eyes in the non-peeling group (P=0.038). Postoperative Amsler testing was positive in five eyes in the peeling group and 13 eyes in the non-peeling group (P=0.024). Complications were similar in both groups; postoperatively, there were one and two cases of iatrogenic peripheral retinal break, three and two cases of macular hole, and one and one case of retinal detachment in the peeling and non-peeling groups, respectively.23G vitrectomy combined with brilliant blue-assisted ILM peeling resulted in better visual and anatomical effects compared with 23G vitrectomy alone in patients with MF.

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Long-term outcome of internal limiting membrane peeling with and without foveal sparing in myopic foveoschisis

Cited by 14 publications

References 26 publications

Vitrectomy with fovea-sparing ILM peeling versus total ILM peeling for myopic traction maculopathy: A meta-analysis

Vitrectomy with fovea-sparing ILM peeling versus total ILM peeling for myopic traction maculopathy: A meta-analysis

Vitrectomy with or without internal limiting membrane peeling for myopic foveoschisis

Outcomes of 23G vitrectomy and internal limiting membrane peeling with brilliant blue in patients with myopic foveoschisis from a retrospective cohort study

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