Scientific correspondence
Phacovitrectomy without prone posture for full thickness macular
holes
Peter R Simcock, Sergio Scalia
West of
England Eye Unit, Royal Devon and Exeter Hospital
Correspondence to: Peter Simcock, West of England Eye Unit, Royal Devon and Exeter Hospital (Wonford), Barrack Road, Exeter EX2 5DW, UK psimcock{at}hotmail.com
Accepted for publication 25 April 2001
AIMS
To investigate
the role of phacovitrectomy surgery without prone posture for stage 2 and 3 macular holes.
METHODSA pilot study
was performed on 20 patients (20 eyes) having phacoemulsification lens
removal and vitrectomy surgery with 20% C2F6
tamponade. Patients were advised to avoid lying on their backs for 10 days following surgery but no other posturing instructions were given.
Closure rates and improvement in visual acuity were compared with a
group of historical controls in whom phacovitrectomy with gas tamponade
and face down posturing was performed.
RESULTSAnatomical
hole closure was noted in 18 of the 20 eyes (90%). 19 eyes (95%)
showed an improvement of at least 0.3 logMAR units. This compares
favourably with the postured group in which anatomical hole closure was
noted in 11 of 13 eyes (85%) and nine of 13 eyes (69%) showed an
improvement of at least 0.3 logMAR units.
CONCLUSIONCombined
surgery facilitates the use of a large gas bubble. Sufficient tamponade
of the hole occurs for closure without prone posturing. Combined
surgery prevents patients posturing and returning for cataract surgery.
© 2001 by British Journal of Ophthalmology
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