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Surgical interventions for lamellar macular holes
Declan C Murphy1, Jon Rees2, David Hw Steel1,3
1Biosciences Institute, Newcastle University, Newcastle upon Tyne, UK.
The Cochrane Database of Systematic Reviews
|November 8, 2021
Summary
Surgery for lamellar macular holes (LMHs) may improve vision and retinal thickness compared to observation. However, evidence is limited due to a single, small study, necessitating further research for definitive conclusions on LMH treatment.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Surgical Interventions
Background:
- Lamellar macular holes (LMHs) are partial-thickness macular defects.
- Characterized by specific optical coherence tomography (OCT) findings, including epiretinal proliferation.
- Surgical intervention is considered for LMHs with functional or anatomical decline, but consensus is lacking.
Purpose of the Study:
- To evaluate the impact of surgical interventions on visual and anatomical outcomes in patients with LMHs.
Main Methods:
- A systematic search of multiple databases (CENTRAL, MEDLINE, Embase, Scopus, etc.) was conducted up to July 2021.
- Included only randomized controlled trials (RCTs) diagnosing LMH and reporting surgical interventions.
- Data extraction and risk of bias assessment were performed independently by two authors.
Main Results:
- One RCT with 36 participants (24 surgery, 12 observation) was included; evidence certainty was low.
- Surgery group showed improved vision (-0.27 logMAR) and retinal sensitivity (+3.03 dB) at six months compared to observation.
- Surgery increased central retinal thickness (+126 μm) versus a decrease in the observation group (-11 μm).
Conclusions:
- The single RCT suggests potential benefits of surgery for LMHs regarding visual acuity and anatomical outcomes.
- Limited evidence from this small RCT cannot definitively support or refute surgical management for LMHs.
- Larger RCTs with reduced bias are required to guide clinical practice for LMH treatment.
