PURPOSE To investigate the effectiveness and safety of posterior scleral reinforcement (PSR) combined with vitrectomy for myopic foveoschisis (MF) treatment. METHODS We conducted a systematic review and meta-analysis. We evaluated the improvement of best-corrected visual acuity (BCVA) in logMAR unit, the percentage of patients with improved or stabled BCVA, benefit on axial length (AL), the retinal reattachment rate, the macular hole (MH) closure rate, as well as the complication rate. RESULTS Fourteen studies (311 eyes) were included. Overall, patients' BCVA improved - 0.46 (95% confidence interval [CI] - 0.52, - 0.40) logMAR unit, with 80% (95%CI 74%, 85%) benefiting from BCVA improvement and 6% (95%CI 3%, 10%) suffering from BCVA loss. Patients' AL was shortened by - 1.74 (95%CI - 2.92, - 0.57) mm, and for patients whose AL was ≥ 30 mm, the average benefit reached - 3.68 (95%CI - 4.59, - 2.77) mm. Ninety-three percent (95%CI 89%, 96%) of the patients achieved retinal reattachment, and 65% (95%CI 47%, 80%) of the MH was closed. Patients' central foveal thickness decreased; the MD was - 187.32 (95%CI - 206.25, - 168.40) mm. The pooled complication rate was 9% (95%CI 8%, 19%), with extrusion, choroidal atrophy, and choroidal neovascularization being the most common complications. Subgroup analysis indicated no statistical difference in BCVA improvement, AL change, retinal reattachment rate, and complication rate between patients with or without MH. Subgroup analysis indicated no statistical difference in the above four outcomes between the primary and the recurrent patients either. There was no statistical difference in the above four outcomes no matter ILM peeling was combined or not. CONCLUSION PSR combined with vitrectomy helps improve 80% MF patients' BCVA; the average benefit on BCVA is - 0.46 logMAR unit. The average change in AL is - 1.74 mm; patients with AL ≥ 30 mm benefit much more than the patients with AL < 30 mm. The retinal reattachment rate is up to 93%; the MH closure rate is 65%. About 9% patients will suffer from extrusion, choroidal atrophy, choroidal neovascularization, and other complications. The outcomes were not influenced by presence of MH, disease recurrence, or ILM peeling.

中文翻译：

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玻璃体切除术治疗后巩膜加固术的有效性和安全性：系统评价和荟萃分析。

目的探讨后巩膜加固（PSR）联合玻璃体切除术治疗近视眼中心凹（MF）的有效性和安全性。方法我们进行了系统的回顾和荟萃分析。我们评估了logMAR单位的最佳矫正视力（BCVA）的改善，BCVA改善或稳定的患者百分比，轴向长度（AL），视网膜复位率，黄斑裂孔（MH）闭合率的获益，如下所示：以及并发症发生率。结果纳入14项研究（311眼）。总体而言，患者的BCVA提高-0.46（95％置信区间[CI]-0.52，-0.40）logMAR单位，其中80％（95％CI 74％，85％）受益于BCVA改善，而6％（95％CI 3） ％，10％）患有BCVA损失。患者的AL缩短了-1.74（95％CI-2.92，-0.57）mm，对于AL≥30 mm的患者，平均获益达到-3.68（95％CI-4.59，-2.77）mm。93％（95％CI 89％，96％）的患者实现了视网膜复位，并且65％（95％CI 47％，80％）的MH闭合。患者中心凹厚度减少；MD为-187.32（95％CI-206.25，-168.40）mm。合并的并发症发生率为9％（95％CI 8％，19％），其中最常见的并发症是挤压，脉络膜萎缩和脉络膜新生血管形成。亚组分析表明，有或没有MH的患者之间，BCVA改善，AL变化，视网膜再附着率和并发症发生率无统计学差异。亚组分析表明，在原发性和复发性患者之间，上述四个结果均无统计学差异。无论是否联合使用ILM剥离，上述四个结果均无统计学差异。结论PSR结合玻璃体切除术可改善80％MF患者的BCVA。BCVA的平均收益为-0.46 logMAR单位。AL的平均变化为-1.74毫米；AL≥30 mm的患者比AL <30 mm的患者受益更多。视网膜复位率高达93％；MH的关闭率为65％。约9％的患者将遭受挤压，脉络膜萎缩，脉络膜新血管形成和其他并发症。结局不受MH的存在，疾病复发或ILM脱皮的影响。AL≥30 mm的患者比AL <30 mm的患者受益更多。视网膜复位率高达93％；MH的关闭率为65％。约9％的患者将遭受挤压，脉络膜萎缩，脉络膜新血管形成和其他并发症。结局不受MH的存在，疾病复发或ILM脱皮的影响。AL≥30 mm的患者比AL <30 mm的患者受益更多。视网膜复位率高达93％；MH的关闭率为65％。约9％的患者将遭受挤压，脉络膜萎缩，脉络膜新血管形成和其他并发症。结局不受MH的存在，疾病复发或ILM脱皮的影响。