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Implantation Protocol of the Foldable Capsular Vitreous Body for Complex Vitreoretinal Surgery

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Face-down posturing after macular hole surgery: a review.

¹Department of Ophthalmology Norfolk and Norwich University Hospital, Norwich, United Kingdom. dgupta_01@yahoo.com

Retina (Philadelphia, Pa.)

|April 11, 2009

Summary

Eliminating face-down posture (FDP) after macular hole surgery is feasible. Studies show successful outcomes without FDP, improving patient recovery and surgical eligibility.

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Area of Science:

Ophthalmology
Retinal Surgery

Background:

Face-down posture (FDP) after macular hole surgery is debated, causing complications and limiting patient eligibility.
The role of FDP is linked to endotamponade mechanics, vitreous involvement in macular hole pathogenesis, and uncertain tamponade mechanisms.
Surgery aims to relieve vitreous traction and promote healing, with FDP potentially aiding preretinal membrane formation and isolating the macula.

Purpose of the Study:

To systematically review literature on the necessity of face-down posture (FDP) in macular hole surgery.
To evaluate outcomes of macular hole surgery with eliminated or reduced duration FDP.

Main Methods:

A literature review and systematic review of studies investigating nil face-down posture (FDP) were conducted.

Main Results:

Studies eliminating or reducing FDP in macular hole surgery demonstrated successful anatomical and visual outcomes.
Eliminating FDP appears to yield comparable results to traditional FDP requirements.

Conclusions:

Isolating the macula is a key function of the endotamponade agent, potentially negating the need for FDP with large, long-acting gas fills.
Eliminating FDP offers benefits such as faster rehabilitation, improved patient compliance, quicker return to work, and increased surgical eligibility.