Idiopathic Macular Hole Vitrectomy Without Postoperative Face-Down Positioning Performed by Different Surgeons

Area of Science:

• Ophthalmology
• Surgical Techniques
• Retinal Diseases

Background:

• Macular holes (MHs) are a significant cause of vision loss.
• Traditional MH repair often requires strict postoperative face-down positioning.
• Alternative surgical strategies are being explored to improve patient comfort and adherence.

Purpose of the Study:

• To assess the efficacy of vitrectomy with internal limiting membrane peeling and sulfur hexafluoride gas tamponade for MH repair.
• To determine outcomes without the need for postoperative face-down positioning.
• To evaluate the procedure's success across multiple surgeons and centers.

Main Methods:

• A retrospective, observational case series of 57 eyes with MHs.
• All patients underwent vitrectomy with internal limiting membrane peeling and 20% sulfur hexafluoride gas tamponade.
• No postoperative face-down positioning was required; visual acuity and hole closure were tracked for 12 months.

Main Results:

• The mean patient age was 65.3 years, with a mean MH duration of 2.37 months.
• An initial hole closure rate of 94.7% was achieved, with a final closure rate of 100%.
• Mean visual acuity significantly improved from 0.65 preoperatively to 0.21 at 12 months post-surgery.

Conclusions:

• Vitrectomy combined with internal limiting membrane peeling and gas tamponade is effective for MH repair.
• The absence of face-down positioning did not compromise anatomic or functional outcomes.
• This technique offers a favorable and potentially more manageable treatment option for macular holes.