title: Anatomical and visual outcomes of macular hole surgery with short-duration 3-day face-down positioning.
abstract: OBJECTIVE
  The role of face-down posturing after macular hole (MH) surgery remains unclear and controversial. We evaluated the anatomical and visual outcomes of MH repair using a short duration (3 days) of prone positioning.
  
  
  METHODS
  Prospective series of 50 consecutive eyes in 50 patients with Stage 2 or Stage 3 idiopathic MHs. All eyes underwent vitrectomy MH surgery with internal limiting membrane peeling and 20% sulfur hexafluoride (SF6) gas tamponade. The procedure was combined with phacoemulsification cataract surgery in phakic eyes. Surgical outcomes, MH closure rates, complications, and postoperative visual acuity were investigated.
  
  
  RESULTS
  Anatomical closure of MHs was achieved in 49 (98%) of 50 eyes by 1 surgery. Postoperative logarithm of the minimum angle of resolution visual acuity decreased (i.e., improved) by 0.271 (95% confidence interval, 0.101-0.441 [P = 0.0024]). One complication of intraocular lens pupillary capture and one case of chronic cystoid macular edema were observed. There were no complications attributed to intraocular pressure fluctuations.
  
  
  CONCLUSIONS
  Vitrectomy with internal limiting membrane peeling and gas tamponade with SF6 followed by short-duration 3-day face-down positioning is a successful surgical intervention for Stage 2 and Stage 3 idiopathic MHs. This method possessed minimal complications and offered significant improvement in visual acuity.
authors.affiliation: Department of Ophthalmology, Queen's University, Hotel Dieu Hospital, Kingston, Ontario, Canada. dalmeida@evolation-medical.com
authors.forename: David R P
authors.initials: DR
authors.lastname: Almeida
authors.forename: Jonathon
authors.initials: J
authors.lastname: Wong
authors.forename: Michel
authors.initials: M
authors.lastname: Belliveau
authors.forename: Jaspreet
authors.initials: J
authors.lastname: Rayat
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Gale
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D002387:Cataract Extraction; D005145:Face; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications; D016684:Prone Position; D011446:Prospective Studies; D012167:Retinal Perforations / Q000601:surgery*; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000009:adverse effects / Q000379:methods*