Jørgen Krohn1. 1. Department of Ophthalmology, University of Bergen, Bergen, Norway. jorgen.krohn@helse-bergen.no
Abstract
PURPOSE: To investigate whether shortening the duration of face-down positioning from 1 week to 3 days affects the anatomical success rate of macular hole surgery. METHODS: A total of 53 consecutive eyes in 50 patients with full thickness macular holes of 2-24 months' (average 10 months) duration were included in the study. In 20 eyes (37.7%) the hole had been present for more than 1 year. All patients were operated with vitrectomy, removal of the posterior hyaloid and a complete fluid-gas exchange. Peeling of the internal limiting membrane (ILM) was not performed. Postoperatively, the duration of face-down positioning differed between two consecutive groups of patients. The first group (29 patients) was instructed to keep their heads face-down for 7 days, while the second group (24 patients) maintained face-down positioning for only 3 days. RESULTS: Overall, 90.6% of the macular holes closed with one operation. The macular hole closed successfully in 27 (93.1%) of the 29 eyes in the 1-week group and in 21 (87.5%) of the 24 eyes in the 3-day group (p > 0.05). CONCLUSION: Although the frequency of hole closure differed slightly in the two study groups, the difference was far from statistically significant. Thus, the results indicate that 3 days of strict face-down positioning are sufficient to achieve closure of even longstanding macular holes without removal of the ILM.
PURPOSE: To investigate whether shortening the duration of face-down positioning from 1 week to 3 days affects the anatomical success rate of macular hole surgery. METHODS: A total of 53 consecutive eyes in 50 patients with full thickness macular holes of 2-24 months' (average 10 months) duration were included in the study. In 20 eyes (37.7%) the hole had been present for more than 1 year. All patients were operated with vitrectomy, removal of the posterior hyaloid and a complete fluid-gas exchange. Peeling of the internal limiting membrane (ILM) was not performed. Postoperatively, the duration of face-down positioning differed between two consecutive groups of patients. The first group (29 patients) was instructed to keep their heads face-down for 7 days, while the second group (24 patients) maintained face-down positioning for only 3 days. RESULTS: Overall, 90.6% of the macular holes closed with one operation. The macular hole closed successfully in 27 (93.1%) of the 29 eyes in the 1-week group and in 21 (87.5%) of the 24 eyes in the 3-day group (p > 0.05). CONCLUSION: Although the frequency of hole closure differed slightly in the two study groups, the difference was far from statistically significant. Thus, the results indicate that 3 days of strict face-down positioning are sufficient to achieve closure of even longstanding macular holes without removal of the ILM.
Authors: Sumit P Shah; Varsha Manjunath; Adam H Rogers; Caroline R Baumal; Elias Reichel; Jay S Duker Journal: Retina Date: 2013-02 Impact factor: 4.256