Inverted ILM flap technique versus conventional ILM peeling for idiopathic large macular holes: A meta-analysis of randomized controlled trials

Guohai Chen; Radouil Tzekov; Fangzheng Jiang; Sihong Mao; Yuhua Tong; Wensheng Li

doi:10.1371/journal.pone.0236431

Peer Review History

Original SubmissionFebruary 24, 2020
5 May 2020 Decision Letter - Shree K. Kurup, Editor PONE-D-20-05200 Inverted ILM flap technique versus conventional ILM peeling for idiopathic large macular holes: a meta-analysis of randomized controlled trials PLOS ONE Dear Dr Li, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. ACADEMIC EDITOR: Please reply to comments by reviewer point by point We would appreciate receiving your revised manuscript by Jun 19 2020 11:59PM. When you are ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. 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Thank you for stating the following financial disclosure:""The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."" Please provide an amended Funding Statement that declares all the funding or sources of support received during this specific study (whether external or internal to your organization) as detailed online in our guide for authors at http://journals.plos.org/plosone/s/submit-now. Please include your amended statements within your cover letter; we will change the online submission form on your behalf. Additional Editor Comments (if provided): please review comments and reply point by point. This MS has intrinsic challenges base don methodology [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: The meta-analysis entitled „Inverted ILM flap technique versus conventional ILM peeling for idiopathic large macular holes: a meta-analysis of randomized controlled trials“ is well-conducted the results sound, the information interesting at a first glance. There are, nevertheless, some aspects deserving closer attention: � Methodologically, a follow up time of 3 months limits the functional meaning of data, so that functional 3-month data should probably be censored. If not, this has to be pointed on in abstract and text. � The gas tamponade has been discussed but not mentioned in the abstract (i.e. no oil) whereas the dye used for staining was not mentioned though possibly a confounder of results (the toxic ICG is bound in the ILM for long time, whereas trypan blue is not. � Abstract: explain or remove type 1 closure rates; explain WMD � Introduction: Remove redundant “however” and improve wording, namely of the last paragraph, lines 57-63. � M&M: include dye used for staining and specify tamponade, both probably in a table which also includes population demographics to help understanding differences. � Confirm, that MH closure types were reported by all 4 studies included here or re-consider primary outcome definition. � Line 88 and lines 115-7, 187: improve wording. � Lines 134-5, 146-7, 162-3: remove, reiterations. � Line 148: remove “with statistically significant” redundancy � Line 172: change to …closure of large MHs � Line 214: replace conformed by confirmed � Table 1: add reference number. Manasa: study quality supportable if standard deviation was not determined? Overall rating for Velez-Montoya low because of a small sample size and a short follow up. To be mentioned, data to be used with specific care. � Figures 2-5: Same order of studies as in the table to facilitate reading. Was the sample size respected for calculation of the OR? Use a decimal or logarithmic scale throughout facilitates reading of the graph. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files to be viewed.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email us at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0236431.r001
Revision 1
2 Jun 2020 Author Response Reviewer #1: The meta-analysis entitled „Inverted ILM flap technique versus conventional ILM peeling for idiopathic large macular holes: a meta-analysis of randomized controlled trials“ is well-conducted the results sound, the information interesting at a first glance. There are, nevertheless, some aspects deserving closer attention: 1.Methodologically, a follow up time of 3 months limits the functional meaning of data, so that functional 3-month data should probably be censored. If not, this has to be pointed on in abstract and text. Response: Two out of the four studies used in the analysis had a follow-up duration of 3 months. Censoring it would incapacitate this meta-analysis. However, we completely agree with the reviewer that this represents a major limitation and should be clearly communicated to the reader. Therefore, we have added this in the revised version of abstract, in addition to this being pointed out as one of the major limitations in the text (Discussion). 2.The gas tamponade has been discussed but not mentioned in the abstract (i.e. no oil) whereas the dye used for staining was not mentioned though possibly a confounder of results (the toxic ICG is bound in the ILM for long time, whereas trypan blue is not. Response: Thank you for this valuable suggestion. We have revised the abstract accordingly and the gas tamponade is now mentioned in the text. We agree that ICG could be bound to ILM for a long time and be toxic to the surrounding tissue. None of the studies selected for this meta-analysis have used ICG; 2 studies used Brilliant Blue G, one used Trypan Blue and one used ILM Blue (just another name for Brilliant Blue G Ophthalmic Solution in other markets outside the USA). The dye used for staining has been mentioned in the revised version of text. We have also added the dye used for staining and specified the type of tamponade in the revised version of Table 1. 3. Abstract: explain or remove type 1 closure rates; explain WMD. Response: We have explained type 1 closure rates and WMD in the revised version of abstract. 4. Introduction: Remove redundant “however” and improve wording, namely of the last paragraph, lines 57-63. Response: We have removed the redundant “however” and reworded this paragraph in the revised version of the text. 5. M&M: include dye used for staining and specify tamponade, both probably in a table which also includes population demographics to help understanding differences. Response: We have added the dye used for staining and specify tamponade in the revised version of Table 1. This information was also added in the revised text of the Materials and Methods. 6. Confirm, that MH closure types were reported by all 4 studies included here or re-consider primary outcome definition. Response: We have revised the primary outcome definition to “anatomic outcome”, and the secondary outcome definition to “visual function outcome” 7. Line 88 and lines 115-7, 187: improve wording. Response: We have reworded these sentences in the revised version of the text. 8. Lines 134-5, 146-7, 162-3: remove, reiterations. Response: We have removed these sentences in the revised version of the text. 9. Line 148: remove “with statistically significant” redundancy. Response: We agree with the reviewers’ comment and have removed the word in the revised version of the text. 10. Line 172: change to …closure of large MHs. Response: Thank you for pointing this out this discrepancy. We have changed it in the revised version of the manuscript. 11. Line 214: replace conformed by confirmed. Response: Thank you for pointing out this typo. We have corrected it. 12.Table 1: add reference number. Response: We have added the reference numbers in the revised version of Table 1. Manasa: study quality supportable if standard deviation was not determined? Response:The standard deviation of macular hole diameter was not available in Manasa (2018) study. This limitation was pointed out in the revised text of the Discussion. Overall rating for Velez-Montoya low because of a small sample size and a short follow up. To be mentioned, data to be used with specific care. Response: We used the Jadad scale to assess the methodologic qualities of RCTs, using 3 criteria: randomization, masking and participant withdrawals/dropouts. The sample size and follow-up time were not included as criteria in the Jadad scale; therefore Velez-Montoya (2018) ended up with 4 points on the Jadad scale. On the other hand, we completely agree with the reviewer that both small sample size and short length of follow-up are major limitations to this (and similar analyses) and have pointed out these limitations in the relevant paragraph in Discussion. 13. Figures 2-5: Same order of studies as in the table to facilitate reading. Response: We have reordered the studies in the Figures to match the order in Table 1. Was the sample size respected for calculation of the OR? Use a decimal or logarithmic scale throughout facilitates reading of the graph. Response: The sample size is accounted for in the calculation of the OR. The models used to generate the plots in Figure 2 and 3 used the Odds Ratio, while the models used to generate the plots in Figure 4 and 5 used the weighted mean difference. Therebefore, the scales for these figures have to be different. Attachments Attachment Submitted filename: Response to Reviewers.doc https://doi.org/10.1371/journal.pone.0236431.r002
8 Jul 2020 Decision Letter - Shree K. Kurup, Editor Inverted ILM flap technique versus conventional ILM peeling for idiopathic large macular holes: a meta-analysis of randomized controlled trials PONE-D-20-05200R1 Dear Dr. Li, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Shree K. Kurup, MD Academic Editor PLOS ONE Additional Editor Comments (optional): This MS is now suitable for consideration Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: After careful revision respecting the reviewer critics, the manuscript now reads interesting and seem acceptable ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes:** Justus G. Garweg https://doi.org/10.1371/journal.pone.0236431.r003
Formally Accepted
14 Jul 2020 Acceptance Letter - Shree K. Kurup, Editor PONE-D-20-05200R1 Inverted ILM flap technique versus conventional ILM peeling for idiopathic large macular holes: a meta-analysis of randomized controlled trials Dear Dr. Li: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Shree K. Kurup Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0236431.r004

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