V. A. Forsaa

Short‐term postoperative non‐supine positioning versus strict face‐down positioning in macular hole surgery

Purpose:  The purpose of this study was to compare the efficacy of short‐term non‐supine positioning (NSP) and strict face‐down positioning (FDP) in the repair of macular hole (MH).

AIR TAMPONADE COMBINED WITH NONSUPINE POSITIONING IN MACULAR HOLE SURGERY FOR PSEUDOPHAKIC EYES.

Purpose: To investigate the closure rate of primary full-thickness macular hole, following intraocular air tamponade combined with a nonsupine positioning regimen. Methods: A prospective study of patients with full-thickness macular hole, who underwent pars plana vitrectomy with internal limiting membrane peeling and intraocular air tamponade followed by 3 days of nonsupine positioning. Outcome measures were primary full-thickness macular hole closure and improvement in best-corrected visual acuity after 6 months. Results: A total of 34 eyes were included. In the group of full-thickness macular hole ⩽400 &mgr;m, primary closure occurred in 95% (19/20), whereas only 57% (8/14) of those >400 &mgr;m closed (P = 0.01). The mean gain in best-corrected visual acuity was 3.5 ETDRS (Early Treatment Diabetic Retinopathy Study) lines (SD = 1.5) (P < 0.01). The air bubble meniscus height at the first postoperative day was estimated to a mean of 59% (range, 50–70%), at the second postoperative day it was 46% (range, 40–55%), and the third day it was 39% (range, 30–45%). Mean intraocular air bubble duration was 10 days (range, 8–13 days). Conclusion: The combination of air tamponade and nonsupine positioning regimen leads to high closure rates for small/medium macular holes (⩽400 &mgr;m), but not for large macular holes (>400 &mgr;m).