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

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Abstract

Purpose

To evaluate the efficacy of vitrectomy with internal limiting membrane peeling and sulfur hexafluoride gas tamponade without postoperative face-down positioning for macular holes (MHs) when performed by 3 surgeons at 2 centers.

Design

A retrospective, consecutive, observational case series.

Methods

Fifty-seven eyes operated on by 1 of 3 surgeons and followed for 12 months after surgery were studied. Exclusion criteria included cases with MH duration longer than 6 months, secondary MH, and clear lenses. The surgical procedure involved cataract extraction and intraocular lens implantation in all phakic eyes before vitrectomy. Internal limiting membrane removal and 20% sulfur hexafluoride gas tamponade without postoperative face-down positioning were performed in all cases. Preoperative factors [age at surgery, sex, symptom duration, visual acuity (VA), MH size, and MH stage], initial and final hole-closure rates and VA at 1, 3, 6, and 12 months after surgery, were evaluated.

Results

Mean patient age was 65.3 years. Of the 57 eyes, 40 were in women, and 17 were in men. Macular hole (mean size, 0.30 disc diameter) was present for a mean of 2.37 months. Eight eyes had stage 2, 37 had stage 3, and 12 had stage 4 MH. Fifty-four holes (94.7%) initially closed. Final closure rate was 100%. Mean VA significantly improved from 0.65 to 0.41 at 1 month, 0.35 at 3 months, 0.28 at 6 months, and 0.21 at 12 months after surgery.

Conclusions

Vitrectomy without face-down positioning for MHs produced favorable anatomic and functional results, regardless of which surgeon performed the procedure.

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