July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Long-term outcome of idiopathic macular hole vitrectomy without postoperative face-down positioning
Author Affiliations & Notes
  • Fumihiko Yagi
    Department of Ophthalmology, Toho University Ohashi Medical Center, Meguro-ku, Tokyo, Japan
  • Tetsuro Takumi
    Department of Ophthalmology, Toho University Ohashi Medical Center, Meguro-ku, Tokyo, Japan
  • Goji Tomita
    Department of Ophthalmology, Toho University Ohashi Medical Center, Meguro-ku, Tokyo, Japan
  • Footnotes
    Commercial Relationships   Fumihiko Yagi, None; Tetsuro Takumi, None; Goji Tomita, Alcon (F), Alcon (R), Fizer (F), Fizer (R), Heidelberg (F), JFC (F), JFC (R), Kowa (F), Kowa (R), Santen (F), Santen (R), Senju (F), Senju (R), Topcon (F), Topcon (R)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 854. doi:
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    • Get Citation

      Fumihiko Yagi, Tetsuro Takumi, Goji Tomita; Long-term outcome of idiopathic macular hole vitrectomy without postoperative face-down positioning. Invest. Ophthalmol. Vis. Sci. 2018;59(9):854.

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

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Abstract

Purpose : To evaluate the long-term outcome of vitrectomy with internal limiting membrane (ILM) peeling and SF6 gas tamponade for macular holes in patients without postoperative face-down positioning.

Methods : Forty-three eyes of 42 patients undergoing pars plana vitrectomy with indocyanine green-assisted ILM peeling and 20% SF6 gas tamponade without postoperative face-down positioning were included in this study. Biomicroscopy and optical coherence tomography were used to assess macular hole closure. Pre- and postoperative visual acuity (VA) were compared. Cases with more than 5 years follow-up were included.

Results : Among the 43 eyes, 10 (23.3%) had stage 2, 24 (55.8%) had stage 3, and 9 (20.9%) had stage 4 macular holes. Mean macular hole size was 0.30 disc diameters. All eyes were phakic. All macular holes initially closed, and no eyes showed reopening. The postoperative mean follow up period was 8.26 years. Preoperative mean VA (logMAR) was 0.59, and mean VA significantly improved to 0.40 at 1 month, 0.28 at 3 months, 0.23 at 6 months, 0.16 at 1 year, 0.10 at 2 years, 0.10 at 3 years, 0.07 at 4 years, 0.07 at 5 years, and 0.07 at the final visit after surgery (p<0.001, repeated measures analysis of variance).

Conclusions : Macular hole surgery with ILM removal and SF6 gas tamponade without postoperative face-down positioning is a potentially useful option for patients for whom postoperative face-down positioning is difficult. In addition, postoperative care without face-down positioning is easier and more convenient. The present findings indicate that improved VA can be expected for up to 4 years after surgery.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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