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Sustained postoperative face-down positioning is unnecessary for successful macular hole surgery


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

Methods: Multicentre 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 seven eyes. Either SF6 or C3F8 gas tamponade was used. The 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. The 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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