title: POSTOPERATIVE POSITIONING IN MACULAR HOLE SURGERY: An Objective Evaluation of Nonsupine Positioning and the Effect of the "Tennis Ball Technique".
abstract: OBJECTIVE
  To objectively evaluate patients' compliance with a nonsupine positioning (NSP) regimen after macular hole surgery and to investigate whether supine positioning time during the first postoperative nights is reduced when a tennis ball is mounted onto the back of the nightshirt.
  
  
  METHODS
  A "position monitoring device" capable of recording the time the head is kept in a supine position was attached to the patient's forehead. In a randomized, controlled, crossover study, the accumulated time each patient spent in a supine position was recorded during two consecutive postoperative nights, both when the "tennis ball technique" (TBT) was used and when it was not, respectively.
  
  
  RESULTS
  The study included 40 participants. A mean supine time of 14 minutes and 47 seconds was registered with the NSP regimen. When applying the TBT, the mean supine time was significantly reduced to 4 minutes and 24 seconds (P = 0.01). Seven "noncompliant" participants with >30 minutes supine time without TBT had the most marked reduction in supine time from a mean of 63 minutes and 2 seconds, to 3 minutes and 46 seconds, with TBT (P = 0.02).
  
  
  CONCLUSIONS
  During an NSP regimen, patients generally maintain a high level of compliance after macular hole surgery. The TBT further improves their compliance significantly.
authors.affiliation: *Department of Ophthalmology, Stavanger University Hospital, Stavanger, Norway; †Department of Clinical Medicine, Section of Ophthalmology, University of Bergen, Bergen, Norway; and ‡Department of Ophthalmology, Haukeland University Hospital, Bergen, Norway.
authors.forename: Vegard Asgeir
authors.initials: VA
authors.lastname: Forsaa
authors.forename: Jørgen
authors.initials: J
authors.lastname: Krohn
mesh_terms: D000368:Aged; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic; D010349:Patient Compliance; D056888:Patient Positioning / Q000379:methods*; D011184:Postoperative Period; D011446:Prospective Studies; D012167:Retinal Perforations / Q000601:surgery*; D016683:Supine Position; D011795:Surveys and Questionnaires; D014821:Vitrectomy; D057586:Vitreoretinal Surgery