Duration of face-down positioning after macular hole surgery: a comparison between 1 week and 3 days.
OBJECTIVE
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).


CONCLUSIONS
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.
Krohn
Jørgen
J
Department of Ophthalmology, University of Bergen, Bergen, Norway. jorgen.krohn@helse-bergen.no
D000328:Adult; D000368:Aged; D001485:Basement Membrane / Q000601:surgery; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D016684:Prone Position; D012167:Retinal Perforations / Q000145:classification / Q000150:complications / Q000601:surgery*; D012591:Scleral Buckling; D013997:Time Factors; D014821:Vitrectomy; D014945:Wound Healing
D005466:Fluorocarbons; C042852:perflutren