title: Pilot randomised controlled trial of face-down posturing following phacovitrectomy for macular hole.
abstract: BACKGROUND
  To gather information on the effect of postoperative face-down posturing following combined phacoemulsification and vitrectomy for macular hole surgery in order to assist in the design of a larger definitive study.
  
  
  METHODS
  Thirty phakic patients with stage II-IV full-thickness macular hole had combined phacoemulsification and pars plana vitrectomy with internal limiting membrane peel and 14% perfluoropropane (C(3)F(8)) gas. At the conclusion of surgery, patients were randomised either to face-down posture or to no posture, for 10 days. The primary outcome was macular hole closure.
  
  
  RESULTS
  The macular hole was successfully closed in 93.8% of the face-down posture group and in all of the no-posture group. Mean visual improvement was 0.63 (SD=0.21) logMAR units in the face-down group and 0.53 (SD=0.22) in the no posture patients.
  
  
  CONCLUSIONS
  Following combined phacoemulsification and vitrectomy, postoperative face-down posturing appears to make little difference to the final anatomical or visual outcome. If we assume a success rate of 95% in the posturing arm, and that there is no difference between posturing and non-posturing, then 798 patients would be required to be 90% sure that the 95% confidence interval will exclude a difference of more than 5%.
authors.affiliation: Vitreo-retinal service, Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, UK. dbyorston@btinternet.com
authors.forename: D
authors.initials: D
authors.lastname: Yorston
authors.forename: M A R
authors.initials: MA
authors.lastname: Siddiqui
authors.forename: M A
authors.initials: MA
authors.lastname: Awan
authors.forename: S
authors.initials: S
authors.lastname: Walker
authors.forename: C
authors.initials: C
authors.lastname: Bunce
authors.forename: J W
authors.initials: JW
authors.lastname: Bainbridge
mesh_terms: D000368:Aged; D016001:Confidence Intervals; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D010865:Pilot Projects; D011182:Postoperative Care / Q000379:methods*; D016684:Prone Position; D012167:Retinal Perforations / Q000601:surgery*; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*
chemical_list: D005466:Fluorocarbons; C042852:perflutren