Recovery of idiopathic macular hole at different stages after surgery: A Systematic Review and Meta-analysis

Background: A systematic review and meta-analysis was conducted to assess the visual function and microstructure recovery of idiopathic macular hole (IMH) at different stages after surgery and its relationship. Methods We systematically searched electronic database from PubMed, Embase and Cochrane Library before June 2022. The primary outcome parameter was the best corrected visual acuity (BCVA) at different time periods after surgery, while the secondary outcome parameter was the percentage or length of recovery of external limiting membrane (ELM) and ellipsoid zone (EZ) at different periods. Results This meta-analysis included 328 eyes from 10 studies. The pooled BCVA significantly improved at every stage (P < 0.05). At the same time, ELM and EZ defects repaired significantly in 1–3 months and 3–6 months after surgery (P < 0.05), which confirmed that 1–6 months were the key time for the rearrangement of the outer layer of the retina. Moreover, EZ layer continued to recover (P < 0.05) during six months after operation. Moreover, there was a significant positive correlation between ELM and EZ (P < 0.0001). Conclusions Recovery of visual function was significantly correlated with ELM layer and EZ layer. The repair of ELM is always prior to that of EZ, and the rearrangement of layers often occurs in 1–6 months. Patients’ vision continued to improved after operation.