title: Short-term postoperative non-supine positioning versus strict face-down positioning in macular hole surgery.
abstract: OBJECTIVE
  The purpose of this study was to compare the efficacy of short-term non-supine positioning (NSP) and strict face-down positioning (FDP) in the repair of macular hole (MH).
  
  
  METHODS
  We retrospectively reviewed all MH repairs over a 27-month period (2008-2010). Inclusion criteria were idiopathic full thickness stage 2-4 MH treated by a single surgeon with 23-gauge pars plana vitrectomy, internal limiting membrane peeling and gas tamponade, followed by postoperative short-term NSP (for 5 days) or strict FDP (for 3-4 days). NSP was achieved by fastening a tennis ball to the back of the nightshirt. Outcome measures were anatomical MH closure verified by optical coherence tomography and postoperative visual acuity.
  
  
  RESULTS
  A total of 67 eyes (64 patients) met the inclusion criteria. The median follow-up period was 6.6 months (range, 4.7-19.8 months). The closure rates following a single operation were 30/33 (90.9%) in the FDP group, and 31/34 (91.2%) in the NSP group, respectively (p = 0.97). The FDP group improved 2.9 ETDRS lines, and 23 eyes (69.7%) gained two or more ETDRS lines. The NSP group improved 2.7 ETDRS lines (p = 1.00), and 25 eyes (73.5%) gained two or more ETDRS lines. The closure rates in the MH subgroup with diameters larger than 400 μm were 20/23 (87.0%) and 15/17 (88.2%) in the FDP group and the NSP group, respectively (p = 0.96).
  
  
  CONCLUSIONS
  The study indicates that short-term NSP is equally effective as strict FDP in the repair of MH. Contrary to previous reports, even large MH did not seem to benefit from FDP.
authors: Department of Ophthalmology, Stavanger University Hospital, Stavanger, Norway. fove@sus.no
authors: Vegard Asgeir
authors: VA
authors: Forsaa
authors: Sten
authors: S
authors: Raeder
authors: Laila Tjelta
authors: LT
authors: Hashemi
authors: Jørgen
authors: J
authors: Krohn
mesh_terms: D000368:Aged; D001485:Basement Membrane / Q000601:surgery; D058450:Endotamponade; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D056888:Patient Positioning / Q000379:methods*; D011184:Postoperative Period; D016684:Prone Position; D012167:Retinal Perforations / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
chemical_list: D005466:Fluorocarbons; C042852:perflutren; D013459:Sulfur Hexafluoride