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[Shortening the duration of prone positioning after macular hole surgery--comparison between one week and one day]
1Department of Ophthalmology, Surugadai Hospital of Nihon University, 1-8-13 Kanda Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan.
Insights
Shortening prone positioning after macular hole surgery to 24 hours is effective. This study found similar initial hole closure rates compared to one week of prone positioning, offering a less burdensome recovery for patients.
Area of Science:
- Ophthalmology
- Surgical Innovation
Background:
- Macular hole surgery traditionally requires one week of prone positioning.
- Optimizing postoperative recovery protocols is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the efficacy of reducing prone positioning duration after macular hole surgery from one week to 24 hours.
- To assess the impact on initial macular hole closure rates.
Main Methods:
- A comparative study involving two groups of patients undergoing macular hole surgery.
- One group maintained prone positioning for one week; the other for 24 hours.
- Exclusion criteria included prior retinal pigment epithelium (RPE) or internal limiting membrane (ILM) removal and long-standing holes.
Main Results:
- No significant differences in preoperative factors were observed between the groups.
- Initial macular hole closure rates were comparable: 91.2% in the one-week group and 90.5% in the 24-hour group.
Conclusions:
- A 24-hour prone positioning period is sufficient for initial hole closure in select macular hole surgery cases.
- This shorter duration can be implemented without compromising closure rates, particularly when RPE or ILM removal is not performed.
Purpose:
We shortened the duration of prone positioning after macular hole surgery from one week to one day and evaluated the initial hole closure rate.
Subject And Method:
The first group included 34 eyes of 33 patients who underwent surgery between April 1998 and August 1999. All 33 patients were instructed to maintain the prone position for one week after surgery (one week group). The second group included 21 eyes of 21 patients who underwent surgery between September 1999 and March 2000. These 21 patients were told to maintain the prone position for 24 hours after surgery (one day group). The indication for surgery was eyes with the reported onset of symptoms within 6 months and without long-standing macular holes. Eyes which underwent retinal pigment epithelium (RPE) or internal limiting membrane (ILM) removal were excluded from the study. Phacoemulsification and intraocular lens implantation were combined in patients with phakic eyes. In the one day group, the patients were instructed to avoid the face up position for one week.
Results:
There were no significant differences between the two groups in terms of preoperative factors, and initial hole closure rates (i.e., 91.2% in the one week and 90.5% in the one day groups).
Conclusion:
These results suggests that the duration of prone positioning after macular hole surgery can be reduced to as little as 24 hours without RPE or ILM removal in eyes without long-standing holes.