RESUMO
PURPOSE: Myopic traction maculopathy is a major cause of visual impairment and blindness, particularly in Asian populations. With the global burden of myopia on the rise, understanding effective treatment options is crucial. This systematic review and meta-analysis evaluate the efficacy of macular buckling in the management of myopic traction maculopathy. DESIGN: A systematic review and meta-analysis. METHODS: A systematic review and meta-analysis were conducted following PRISMA guidelines. PubMed, Cochrane Library, and EMBASE databases were searched for relevant studies up to July 2024. Inclusion criteria encompassed studies reporting outcomes of macular buckling for myopic traction maculopathy. Primary outcomes included changes in best-corrected visual acuity (BCVA) and axial length, retinal reattachment rate, and macular hole closure rate. Random-effect models were used for statistical analysis, with heterogeneity assessed using the I² statistic. The pooled results were reported as mean difference or proportion with corresponding 95% confidence intervals (CI) for each outcome. RESULTS: Thirteen studies (482 eyes) met the inclusion criteria. Significant improvements in BCVA were observed across all follow-up periods, with the most substantial improvement in long-term outcomes (mean difference: 0.38 logMAR; 95% CI: 0.28 to 0.47). Axial length showed consistent reductions, with a mean long-term reduction of 2.88 mm (95% CI: 2.54 to 3.21). The pooled long-term retinal reattachment rate was 94% (95% CI: 86-97%), while the long-term full thickness macular hole closure rate was 72% (95% CI: 55-85%). Heterogeneity varied across outcomes and follow-up periods, ranging from low to high. CONCLUSION: Macular buckling demonstrates promising outcomes for myopic traction maculopathy, including improved visual acuity, reduced axial length, high retinal reattachment rates, and favorable macular hole closure rates. These findings support the efficacy of macular buckling as a treatment option for myopic traction maculopathy. However, further standardized, long-term studies are needed to confirm these results and explore potential combination therapies.