J Korean Ophthalmol Soc.  2013 Nov;54(11):1723-1730. 10.3341/jkos.2013.54.11.1723.

Comparison of Prone and Seated Position after Vitrectomy for Idiopathic Macular Hole Surgery

• Park JH
• Chang WH
• Sagong M

• KMID: 2217920
• DOI: http://doi.org/10.3341/jkos.2013.54.11.1723

Abstract

PURPOSE
To compare the anatomical and functional results of vitrectomy for macular hole with and without prone posture.
METHODS
We retrospectively reviewed the medical records of 71 eyes of 71 patients who received macular hole repair and were followed up for at least 6 months. The anatomical success, complications, and best corrected visual acuity at postoperative 6 months and last follow-up between patients who were advised to take a prone posture for 1 week (group 1) and patients who were advised to simply avoid the supine position right from the surgery (group 2) were analyzed. Subgroup division analysis according to macular hole size and concurrent phacoemulsification was performed.
RESULTS
Macular hole closure rate was 91.7% (33 of 36 eyes) in group 1 and 88.6% (31 of 35 eyes) in group 2 (p=0.710). The mean visual acuity at final follow-up increased in both groups by 4.75 +/- 3.83 and 4.76 +/- 2.96 lines, respectively and revealed no statistically significant difference (p = 0.988). Twenty-seven of 36 eyes (75%) in group 1 and 30 of 35 eyes (85.7%) in group 2 underwent concurrent phacoemulsification, and no difference in macular hole closure rate and visual acuity improvement between the two postures was observed.
CONCLUSIONS
Favorable anatomical and functional outcomes were achieved without postoperative face-down posturing in the case of phacovitrectomy with wide internal limiting membrane peeling and gas tamponade.

Keyword

Macular hole; Phacovitrectomy; Postoperative posture; Vitrectomy

MeSH Terms

Follow-Up Studies
General Surgery*
Humans
Medical Records
Membranes
Phacoemulsification
Posture
Retinal Perforations*
Retrospective Studies
Supine Position
Visual Acuity
Vitrectomy*

Figure

• 

  Figure 1. Anatomical success rate between group with macular holes smaller than 400 μm and group with macular holes 400 μm or larger. There was no significant difference between prone and seated position in both groups (Fisher exact test; p = 0.653, p = 1.000).

• 

  Figure 2. Anatomical success rate between phacovitrectomy group and vitrectomy group. There was no significant difference between prone and seated position in both groups (Fisher's exact test & Pearson's Chi-square test; p = 1.00, p = 1.00).

• 

  Figure 3. Postoperative change in visual acuity at 6 month and final follow-up between group with macular holes smaller than 400 μm and group with macular holes 400 μm or larger. There was no significant difference between prone and seated position in each group (Fisher's exact test & Pearson's Chi-square test; p = 0.653, p = 0.629, p = 0.293, p = 0.471).

• 

  Figure 4. Postoperative change in visual acuity between phacovitrectomy group and vitrectomy only group at 6 month and final follow-up. There was no significant difference between prone and seated position in each group at postoperative 6 months and final follow-up (Fisher's exact test & Pearson's Chi-square test; p = 0.542, p = 0.095, p = 0.506, p = 0.158).

Reference

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