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Vitrectomy with or without internal limiting membrane peeling for idiopathic epiretinal membrane: A meta-analysis

Author

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  • Wei-Cheng Chang
  • Chin Lin
  • Cho-Hao Lee
  • Tzu-Ling Sung
  • Tao-Hsin Tung
  • Jorn-Hon Liu

Abstract

Background: Studies on vitrectomy with and without internal limiting membrane (ILM) peeling for idiopathic epiretinal membrane (ERM) have yielded uncertain results regarding clinical outcomes and recurrence rates. Objective: To compare the clinical outcomes of vitrectomy with and without ILM peeling for idiopathic ERM. Methods: Databases, including PubMed, Embase, Cochrane, Web of Science, Google Scholar, CNKI databases, FDA.gov, and ClinicalTrials.gov, published until July 2016, were searched to identify studies comparing the clinical outcomes following vitrectomy with ERM and ILM peeling and with only ERM peeling, for treating idiopathic ERM. Studies with sufficient data were selected. Pooled results were expressed as mean differences (MDs) and risk ratios (RRs) with corresponding 95% confidence intervals (CI) for vitrectomy with and without ILM peeling with regard to postoperative best corrected visual acuity (BCVA), central retinal thickness (CRT), and ERM recurrence rate. Results: Eleven retrospective studies and one randomized controlled trial involving 756 eyes were identified. This demonstrated that the postoperative BCVA within 12 months was significantly better in the non-ILM peeling group (MD = 0.04, 95% CI: 0.00 to 0.08; P = 0.0460), but that the patients in the ILM peeling group had significantly better postoperative BCVA after 18 months (MD = −0.13, 95% CI: −0.23 to −0.04; P = 0.0049) than did those in the non-ILM peeling group. The non-ILM peeling group exhibited a higher reduction in postoperative CRT (MD = 51.55, 95% CI:−84.23 to −18.88; P = 0.0020) and a higher recurrence rate of ERM (RR = 0.34, 95% CI:0.16 to 0.72; P = 0.0048) than did the ILM peeling group. However, the improvement rates of BCVA (RR = 1.03, 95% CI:0.72 to 1.47; P = 0.8802) and postoperative CRTs (MD = 18.15, 95% CI:−2.29 to 38.60; P = 0.0818) were similar between the two groups. Conclusions: Vitrectomy with ILM peeling results in better visual improvement in long-term follow-ups and lower ERM recurrence rates, and vitrectomy with only ERM peeling is more efficacious in reduction of CRT than is vitrectomy with ILM peeling.

Suggested Citation

  • Wei-Cheng Chang & Chin Lin & Cho-Hao Lee & Tzu-Ling Sung & Tao-Hsin Tung & Jorn-Hon Liu, 2017. "Vitrectomy with or without internal limiting membrane peeling for idiopathic epiretinal membrane: A meta-analysis," PLOS ONE, Public Library of Science, vol. 12(6), pages 1-18, June.
    • Handle: RePEc:plo:pone00:0179105
    DOI: 10.1371/journal.pone.0179105
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    1. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    2. Viechtbauer, Wolfgang, 2010. "Conducting Meta-Analyses in R with the metafor Package," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 36(i03).
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    1. Matteo Fallico & Andrea Russo & Antonio Longo & Alfredo Pulvirenti & Teresio Avitabile & Vincenza Bonfiglio & Niccolò Castellino & Gilda Cennamo & Michele Reibaldi, 2018. "Internal limiting membrane peeling versus no peeling during primary vitrectomy for rhegmatogenous retinal detachment: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 13(7), pages 1-12, July.
    2. Qinying Huang & Jinying Li, 2021. "With or without internal limiting membrane peeling during idiopathic epiretinal membrane surgery: A meta-analysis," PLOS ONE, Public Library of Science, vol. 16(1), pages 1-15, January.

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