April 2011
Volume 52, Issue 14
ARVO Annual Meeting Abstract  |   April 2011
Strict Face Down Positioning Compared With No Face Down Positioning In The Repair Of Macular Hole
Author Affiliations & Notes
  • Vegard A. Forsaa
    Ophthalmology, Stavanger University Hospital, Stavanger, Norway
  • Laila T. Hashemi
    Ophthalmology, Stavanger University Hospital, Stavanger, Norway
  • Sten Raeder
    Ophthalmology, Stavanger University Hospital, Stavanger, Norway
  • Joergen Krohn
    Ophthalmology, Haukeland University Hospital, Bergen, Norway
  • Footnotes
    Commercial Relationships  Vegard A. Forsaa, None; Laila T. Hashemi, Alcon (R); Sten Raeder, None; Joergen Krohn, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 4492. doi:
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      Vegard A. Forsaa, Laila T. Hashemi, Sten Raeder, Joergen Krohn; Strict Face Down Positioning Compared With No Face Down Positioning In The Repair Of Macular Hole. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4492.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: : To compare strict postoperative face down positioning (FDP) with no FDP in the repair of macular hole (MH).

Methods: : A total of 74 consecutive patients underwent surgical repair of MH at Stavanger University Hospital, Norway, over a 27-month period (July 2, 2008 - November 10, 2010). All surgeries were carried out by a single surgeon (VAF). The initial 37 patients were subjected to a strict hospitalized postoperative FDP for 3 days (stage 4 MH; 4 days), whereas the following 37 patients received no postoperative FDP. For a period of 5 postoperative days the patients in the non-FDP group were instructed not to gaze upwards or sleep on their back. The latter was achieved by fastening a tennis ball to the back of the nightshirt. A complete 23-gauge pars plana vitrectomy followed by internal limiting membrane peeling and gas tamponade were applied. Follow-up data were collected at the visit closest to 3 months postoperatively. Closed MH was defined as anatomical closure verified by optical coherence tomography. Mann-Whitney U test and Chi-Square test were used to compare the groups.

Results: : No statistically significant differences were found on age, gender, and staging of macular hole. In the FDP group mean age was 68.0 years, 75.7% were females, 6 (16.2%) stage 2 MH, 21 (56.8%) stage 3 and 10 (27.0%) stage 4. In the non-FDP group mean age was 72.1 years, 75.7% were females, 11 (29.2%) stage 2 MH, 16 (43.2%) stage 3 and 10 (27.0%) stage 4. Preoperative visual acuity (VA) in the FDP group was logMAR 0.73 compared to 0.75 in the non-FDP group (p=0.41). Mean FDP was 3.24 days. The mean follow-up period was 79.7 days and 53.3 days in the FDP and the non-FDP group, respectively. Closure rates after one surgery were 33/37 (89.2%) in both groups. Patients in the FDP group improved 9.5 ETDRS letters compared with 6.2 (p=0.24) in the non-FDP group.

Conclusions: : The findings indicate that no postoperative FDP is equally as effective as strict postoperative FDP in the repair of MH.

Keywords: macular holes • vitreoretinal surgery • retina 

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