The following is a summary of “Novel surgical approaches for treating myopic traction maculopathy: a meta-analysis,” published in the March 2024 issue of Ophthalmology by Quiroz-Reyes et al.

Myopic traction maculopathy (MTM) arises from tractional changes in pathological myopia, leading to retinoschisis, foveal retinal detachment, and lamellar or full-thickness macular holes (FTMHs).

Researchers conducted a retrospective study to assess the safety and efficacy of innovative surgical approaches for treating MTM.

They conducted a comprehensive search across multiple databases, including Web of Science, PubMed, Scopus, ClinicalTrials.gov, the Cochrane Central Register of Controlled Trials, Ovid MEDLINE, Embase, and the Meta-Register of Controlled Trials, to compare the outcomes of various surgical approaches for MTM. The meta-analysis was conducted using RevMan 5.1.

The results showed that 9 comparative studies encompassing 350 eyes were analyzed in the meta-analysis. Significant disparities were observed between fovea-sparing internal limiting membrane peeling (FSIP) and standard internal limiting membrane peeling (ILMP). Preoperative best-corrected visual acuity BCVA (standard mean difference (SMD): -0.10, 95% CI: -0.32 to 0.12) and central foveal thickness CFT (SMD: 0.05, 95% CI: -0.22 to 0.33) did not exhibit significant differences (P=0.39 and P=0.71). Postoperative BCVA showed a considerable improvement (SMD = − 0.47, 95% CI: − 0.80, − 0.14, P=0.006) in the FSIP group compared to the standard ILMP group. Postoperative CFT did not significantly differ between the two groups (P=0.62). Anatomical success rate was slightly higher in the FSIP group, although not statistically significant (P=0.26). The incidence of postoperative macular hole formation was significantly lower (OR = 0.19, 95% CI = 0.07–0.54; P=0.05) in the FSIP group compared to the standard ILMP group. The unique characteristics of highly myopic eyes, such as increased axial length and structural changes, may have contributed to the higher incidence of FTMH in the ILMP group.

Investigators concluded that the meta-analysis suggested FSIP as the preferred initial surgery for early MTM, but further studies are needed to compare different surgical techniques for various MTM stages.

Source: bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-024-03374-0