Posturing time after macular hole surgery modified by optical coherence tomography images: a pilot study.
OBJECTIVE
To see the early postoperative stage of macular hole (MH) surgery and to distinguish eyes needing prolonged posturing from those that do not use Fourier-domain optical coherence tomography (FD-OCT).


METHODS
Interventional case series.


METHODS
Sixteen eyes of 15 patients with MH underwent the protocol at Kagoshima University Hospital. After the pars plana vitrectomy with 16% SF(6) gas tamponade followed by posturing, the eyes were examined by FD OCT from 3 hours to the day after surgery. After MH closure was confirmed, posturing was stopped. Follow-up was performed for 4 months or longer. The main outcome measures included time and OCT finding of MH closure after surgery.


RESULTS
On the day after surgery, the macula could be examined by FD-OCT in 13 of 16 eyes; 10 eyes had a closed MH and 3 had an unclosed MH. At day 2, 2 of the 3 eyes with unclosed MHs on day 1 demonstrated a closed MH. Posturing continued for 8 days in 4 eyes whose MH closure was not confirmed. The MH was closed in all eyes within 1 month. FD-OCT showed bridge formation of the neural retina in 9 eyes and simple closure in 3 eyes within 7 days. At 1 month, 12 eyes showed simple closure and 4 eyes showed bridge formation. Among 9 eyes with bridge formation within 7 days, 6 eyes had changed to simple closure at 1 month.


CONCLUSIONS
FD-OCT enabled confirmation of MH closure the day after surgery even in gas-filled eyes. This imaging method may be a good indicator to determine when to stop posturing for each patient.
Masuyama
Kyoko
K
Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Japan.
Yamakiri
Keita
K
Arimura
Noboru
N
Sonoda
Yasushi
Y
Doi
Norihito
N
Sakamoto
Taiji
T
D000368:Aged; D005260:Female; D005583:Fourier Analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011184:Postoperative Period; D016684:Prone Position; D012167:Retinal Perforations / Q000145:classification / Q000503:physiopathology / Q000601:surgery*; D013459:Sulfur Hexafluoride / Q000008:administration & dosage*; D013997:Time Factors; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
D013459:Sulfur Hexafluoride