Surgery Outcomes of Lamellar Macular Eyes with or without Lamellar Hole-Associated Epiretinal Proliferation: A Meta-Analysis

Abstract

Background: To compare the visual outcomes and rate of restored ellipsoid zone (REZ) after surgery of lamellar macular hole (LMH) with and without lamellar hole-associated epiretinal proliferation (LHEP). Method: Publications up to November 2019 that compared the outcomes of LMH patients with and without LHEP who were managed by surgery were included. Forest plots were created using a weighted summary of proportion meta-analysis. A random effects mode was used and I2 heterogeneity estimates were calculated. Sensitivity analysis was carried out to evaluate the stability of the meta-analysis.Result:Four pertinent publications studying a total of 157 patients with 99 eyes without LHEP and 58 eyes with LHEP were identified. They were all retrospective studies and had a mean follow-up of at least 6 months. In all studies, the best corrected visual acuity (BCVA) had no significant differences before surgery and improved in both groups, and in two studies the post-operative BCVA had no significant differences between two groups. The rate of restored ellipsoid zone (REZ) was different among studies included. Meta-analytic pooling of the improved BCVA between with and without LHEP groups was 0.15 (95 % CI, 0.02 to 0.27; P=0.02), and the pooled data revealed an odd ratio of 2.67 (95% CI, 0.50 to 14.25; p = 0.25) in the rate of REZ, comparing the group without LHEP and the group with LHEP.Conclusion: Patients without LHEP had better postoperative BCVA than patients with LHEP, while no significant difference was found in REZ among the two groups.