PT - JOURNAL ARTICLE AU - Xiao-Ling Fang AU - Yao Tong AU - Ya-Li Zhou AU - Pei-Quan Zhao AU - Zhao-Yang Wang TI - Internal limiting membrane peeling or not: a systematic review and meta-analysis of idiopathic macular pucker surgery AID - 10.1136/bjophthalmol-2016-309768 DP - 2017 Nov 01 TA - British Journal of Ophthalmology PG - 1535--1541 VI - 101 IP - 11 4099 - http://bjo.bmj.com/content/101/11/1535.short 4100 - http://bjo.bmj.com/content/101/11/1535.full SO - Br J Ophthalmol2017 Nov 01; 101 AB - Purpose To determine whether internal limiting membrane (ILM) peeling improves anatomical and functional outcomes in idiopathic macular pucker (IMP)/epiretinal membrane (ERM) surgery in this systematic review and meta-analysis.Methods We searched the PubMed, Medline, Web of Science, Cochrane, Ovid MEDLINE, ClinicalTrials.gov and CNKI databases for studies published before 15 September 2016. The eligibility criteria included studies comparing ILM peeling versus no-peeling for IMP surgery.Results Thirteen articles (10 retrospective cohort studies, 1 prospective cohort study and 2 randomised controlled trials (RCTs)) were included in the review. Primary outcomes: no differences were observed in the best-corrected visual acuity (BCVA) or central macular thickness (CMT) at 12 months; however, lower ERM recurrence (OR, 0.13; 95% CI 0.04 to 0.41; p=0.0004) and reoperation rates (OR, 0.10; 95% CI 0.02 to 0.49; p=0.004) that favoured ILM peeling were observed at the final follow-up. Secondary outcomes: no difference was observed in BCVA at 3, 6 months, the final follow-up or in CMT at 3, 6 months, the final follow-up. Significantly increased CMT, which favoured ILM peeling, was observed at the final follow-up (p=0.002) in the RCTs.Conclusions ILM peeling yielded greater anatomical success, but no improvement in functional outcomes as the treatment of choice for patients undergoing IMP surgery.