title: Comparison of face-down and seated position after idiopathic macular hole surgery: a randomized clinical trial.
abstract: OBJECTIVE
  To compare two therapeutic modalities on anatomic and functional results after idiopathic macular hole (MH) surgery: seated vs face-down position.
  
  
  METHODS
  Multicenter, prospective, randomized trial.
  
  
  METHODS
  
  
  
  METHODS
  University Hospital Dijon and University Hospital Nancy.
  
  
  METHODS
  One hundred and forty-four patients (150 eyes) were enrolled and randomly separated into two groups for postoperative position: for the 72 eyes in the P0 group and the 78 eyes in the P1 group, the patients were asked to keep the seated (P0 group) and the face-down position (P1 group) after the idiopathic MH surgery.
  
  
  METHODS
  All patients underwent a complete vitrectomy with a fluid-air exchange and an intraocular gas tamponade. After the surgery, patients were asked to keep one of the two randomly chosen positions for five days.
  
  
  METHODS
  Best-corrected visual acuity (VA), fundus examination, and macular optical coherence tomography were performed before and six months after surgery.
  
  
  RESULTS
  The overall anatomic success rate was 92.7%. The idiopathic MH sealed in 63 of 72 P0 eyes (87.5%) and 76 of 78 P1 eyes (97.4%) (P = .027). The mean VA increased from 0.86 to 0.61 logMAR (0.88 to 0.61 in P0 and 0.84 to 0.60 in P1). However, in a post hoc analysis based on the size of the idiopathic MH, the success rate in idiopathic MHs smaller than 400 microm was not influenced by the postoperative position (P = .47).
  
  
  CONCLUSIONS
  A face-down postoperative position is highly recommended in holes larger than 400 microm. The size of the idiopathic MH seems to be an important factor affecting outcome.
authors.affiliation: Department of Ophthalmology, University Hospital Dijon, Rue du Faubourg Raines, Dijon, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Guillaubey
authors.forename: Laure
authors.initials: L
authors.lastname: Malvitte
authors.forename: Pierre Olivier
authors.initials: PO
authors.lastname: Lafontaine
authors.forename: Nicolas
authors.initials: N
authors.lastname: Jay
authors.forename: Isabelle
authors.initials: I
authors.lastname: Hubert
authors.forename: Alain
authors.initials: A
authors.lastname: Bron
authors.forename: Jean Paul
authors.initials: JP
authors.lastname: Berrod
authors.forename: Catherine
authors.initials: C
authors.lastname: Creuzot-Garcher
mesh_terms: D000368:Aged; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D006801:Humans; D008297:Male; D011182:Postoperative Care / Q000379:methods; D016684:Prone Position; D011446:Prospective Studies; D012167:Retinal Perforations / Q000175:diagnosis / Q000601:surgery*; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy
chemical_list: D005466:Fluorocarbons; C048381:perfluoroethane; C042852:perflutren; D013459:Sulfur Hexafluoride