SynthesisOphthalmic research2021
Inverted Internal Limiting Membrane Flap Technique versus Internal Limiting Membrane Peeling for Large Macular Holes: A Meta-Analysis of Randomized Controlled Trials.
Synthesis in Ophthalmic research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Critical analysis of macular hole repair techniques: a comprehensive systematic review and meta-analysis comparing internal limiting membrane flap and internal limiting membrane peeling for any size of macular hole.BMC ophthalmology · 2025Pooled it
- ILM flap coverage versus conventional ILM peeling for idiopathic full-thickness macular hole: a retrospective cohort study.Frontiers in medicine · 2026Article
- Inverted internal limiting membrane flap technique versus internal limiting membrane removal in large macular hole with different hole edge configurations: a comparative study.Frontiers in medicine · 2026Article
- Comparison of ILM peeling vs. inverted ILM flap for macular hole closure and visual outcomes: systematic review and meta-analysis.International journal of retina and vitreous · 2025Review
- A delphi consensus study for treatment of full-thickness macular hole in Taiwan.Scientific reports · 2025Article
- Macular hole repair using a refined viscoelastic assisted membrane positioning technique markedly improves surgical success rates.International ophthalmology · 2025Article
- Multilayered Inverted Internal Limiting Membrane Flap Technique in Optic Disc Pit Maculopathy.Turkish journal of ophthalmology · 2024Article
- Proliferative gliosis, a rare finding following multilayered inverted internal limiting membrane flap technique for concurrent macular hole and retinal detachment: Case series.American journal of ophthalmology case reports · 2024Article
- Pars plana vitrectomy with internal limiting membrane flap versus pars plana vitrectomy with conventional internal limiting membrane peeling for large macular hole.The Cochrane database of systematic reviews · 2023Review
- Visual Improvement Despite Macular Pucker After Inverted Internal Limiting Membrane Flap Technique for Idiopathic Macular Hole.Journal of vitreoretinal diseasesArticle
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundVitrectomy with internal limiting membrane (ILM) peeling is an effective surgical procedure for the treatment of macular holes (MHs). However, there is a possibility of poor postoperative anatomical closure with conventional ILM peeling for MHs larger than 400 μm. Therefore, a novel inverted ILM flap technique was developed for such cases.
objectivesThis meta-analysis study was performed to evaluate and compare the anatomical and visual outcomes of the inverted ILM flap technique and ILM peeling in large MHs.
methodsThe Cochrane Library, PubMed, and Embase databases were searched to identify randomized controlled trials (RCTs). The trial eligibility and risk of bias were assessed according to Cochrane review methods. The primary outcome measures included MH closure rate and postoperative visual acuity (VA). Subgroup analysis of postoperative VA based on follow-up time was also conducted. Pooled odds ratios (ORs), weighted mean difference (WMD), and 95% confidence intervals (CIs) were calculated. Statistical analysis was performed using RevMan 5.3 software.
resultsFive RCTs with a total of 155 eyes in the inverted ILM flap group and 161 eyes in the ILM peeling group were included in this meta-analysis. Statistical meta-analysis revealed that the overall MH closure rate in the inverted ILM flap group was significantly higher than that in the ILM peeling group (OR = 3.10; 95% CI: 1.25-7.66; p = 0.01). The postoperative VA was significantly better in the inverted ILM flap group than the ILM peeling group (WMD = -0.14; 95% CI: -0.21 to -0.07; p = 0.0002). The subgroup meta-analysis indicated that the postoperative VA was significantly better in the inverted ILM flap group than the ILM peeling group (WMD = -0.17; 95% CI: -0.26 to -0.08; p = 0.0004) at the 3-month follow-up. However, no significant difference was observed between the 2 groups at the 6-month follow-up (WMD = -0.09; 95% CI: -0.20 to 0.02; p = 0.10).
conclusionsVitrectomy with the inverted ILM flap technique showed a higher anatomical closure rate as well as visual gain - although only in the short term as no difference in visual recovery was found at the 6-month follow-up - than did ILM peeling in large MHs. The inverted ILM flap technique should be considered as a preferred and routine procedure for the treatment of patients with MHs larger than 400 µm.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.