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Sustained Postoperative Face-down Positioning is Unnecessary for Successful Macular Hole Surgery
  1. Robert A Mittra (rmittra1{at}mac.com),
  2. Judy E Kim (judykim{at}mcw.edu),
  3. Dennis P Han,
  4. John S Pollack
  1. Vitreo Retinal Surgery, United States
  2. Medical College of Wisconsin, United States
  3. Medical College of Wisconsin, United States
  4. Illinois Retina Associates, United States

    Abstract

    Purpose: To determine the rate of successful macular hole closure with 1 day postoperative prone positioning.

    Methods: Multi-center review of all consecutive cases of stage 3 and 4 macular hole surgery performed during a 15-month period employing 1 day postoperative face-down positioning regimen. Cataract surgery was not routinely combined with macular hole surgery. Internal limiting membrane peeling was employed in all but 7 eyes. Either SF6 or C3F8 gas tamponade was used. Primary outcome assessed was the rate of hole closure.

    Results: 56 eyes of 53 patients were identified. 79% of eyes had stage 3 macular holes and 39 of 56 (70%) eyes were phakic at the time of surgery. Mean preoperative logMAR vision was 0.74 (~20/100 Snellen) and mean postoperative logMAR vision was 0.41 (~20/50 Snellen) with a mean follow-up period of 5.2 months. Macular hole closure was achieved in 52 eyes (93%) with one operation.

    Conclusion: Sustained postoperative face-down positioning may not be necessary for successful macular hole closure, since 93% of eyes achieved hole closure with prone positioning for only 1 day.

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