Successful macular hole closure

It is not necessary for patients to remain face-down for more than 24 hours to ensure successful macular hole closure, according to study results published online ahead of print by the British Journal of Ophthalmology.

Judy E. Kim of the Medical College of Wisconsin, United States and colleagues conducted a 15-month multicentre review of patients (n=53; eyes, n=56) undergoing consecutive stage 3 and 4 macular hole surgeries. Mean preoperative visual acuity was 0.74 logMAR (20/100 Snellen). Surgery was not routinely combined with phacoemulsification, but internal limiting membrane (ILM) peeling, using either SF6 or C3F8 gas tamponade, was conducted in 49 eyes. Of the eyes undergoing surgery, 79% had stage 3 macular holes and 70% were phakic.

Macular hole closure was achieved by just one operation in 93% of eyes (n=52). Mean postoperative visual acuity was 0.41 logMAR (20/50 Snellen). The mean follow-up period was 5.2 months.

Therefore the researchers concluded that - since macular hole closure was achieved in the majority of cases by just one operation with only one day of prone positioning - sustained prone positioning is not necessary for successful hole closure.