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J. Heffez, A. C. Kopel, P. E. Carvounis, E. R. Holz; Comparison of Macular Hole Repair With and Without Prone Positioning. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4701.
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To compare the anatomic outcomes of pars plana vitrectomy using perfluoropropane with and without postoperative prone positioning for repair of macular holes.
Retrospective chart review of 57 consecutive patients who underwent pars plana vitrectomy by a single surgeon for repair of stage 2-4 macular holes using perfluoropropane with (n=37) and without postoperative prone positioning (n=20) and at least 2 months follow-up. No patient underwent postoperative augmentation of the gas bubble.
The overall closure rate was 84.2% (95% confidence interval [CI]: 73%-92%). There was no statistically significant difference (p=0.25, Fisher Exact Test) between patients who maintained postoperative prone positioning (89%, 95% CI: 75-96%) and those who did not (75%, 95% CI: 53-89%). The closure rate was similar in pseudophakic (including eyes that underwent combined phacovitrectomy) and phakic eyes among patients who did not position (p=0.99). The 2 groups had no significant difference in the distribution of macular hole stage (p=0.74, Fisher Exact Test), however, internal limiting membrane peeling was performed more frequently in the prone positioning group (p=0.05, Fisher Exact Test).
In our study, macular hole closure rates were not significantly different in two groups of patients with and without prone positioning.
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