May 22, 2013
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Face-down position may be unnecessary in repair of macular holes

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LA JOLLA, Calif. — Face-down positioning was unnecessary to repair full-thickness macular holes, according to a poster presentation here.

Face-down positioning is not necessary to successfully close macular holes and substantially adds to the postoperative burden of patients,” Paul E. Tornambe, MD, and Nikolas J.S. London, MD, said in a poster presentation at the American Ophthalmological Society meeting.

The retrospective study included 81 patients with full-thickness macular holes less than 750 µm in diameter who were treated by a single surgeon using 23-gauge pars plana vitrectomy, indocyanine green-assisted peeling of the internal limiting membrane and fluid-gas exchange with 25% SF6 gas.

No patients were instructed to use face-down positioning at any time after surgery; however, they were told to refrain from supine positioning.

There was a 97% success rate for macular hole closure with a single operation, with a 3% rate of retinal detachment.

Eighty-four percent of eyes achieved visual acuity of 20/50 or better.

Disclosure: Tornambe has no relevant financial disclosures.