Skip to main content

Advertisement

SpringerLink
Log in

Idiopathic macular hole vitrectomy without postoperative face-down positioning

  • Clinical Investigation
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the efficacy of vitrectomy with internal limiting membrane (ILM) peeling and SF6 gas tamponade for macular holes without face-down positioning.

Methods

Twenty-one eyes of 21 consecutive patients undergoing pars plana vitrectomy with indocyanine green-assisted ILM peeling and 20% SF6 gas tamponade without face-down positioning were included in this study. Biomicroscopy and optical coherence tomography were used to assess macular hole closure. Pre- and postoperative visual acuities (VAs) were compared.

Results

Among the 21 eyes, five (23.8%) had stage 2, 11 (52.4%) stage 3, and five (23.8%) stage 4 macular holes. Mean macular hole size was 0.35 disc diameters. The macular holes had been present for an average of 2.3 months. Twenty eyes (95.2%) were phakic, and one (4.8%) was pseudophakic. Nineteen of the 21 holes (90.5%) initially closed. The final closure rate was 100%, and no eyes showed reopening. Preoperative mean VA (logMAR) was 0.65, and mean VA had significantly improved to 0.46 at 1 month and to 0.42 at 3 months after surgery (P < 0.0001, repeated measures analysis of variance).

Conclusion

Vitrectomy with ILM peeling and SF6 gas tamponade for macular holes without face-down positioning achieved favorable anatomical and functional results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kelly NE, Wendel RT. Vitreous surgery for idiopathic macular holes. Result of a pilot study. Arch Ophthalmol 1991;109:654–659.

    CAS  PubMed  Google Scholar 

  2. Holekamp NM, Meredith TA, Landers MB, et al. Ulnar neuropathy as a complication of macular hole surgery. Arch Ophthalmol 1999;117:1607–1610.

    CAS  PubMed  Google Scholar 

  3. Treister G, Wygnanski T. Pressure sore in a patient who underwent repair of a retinal tear with gas injection. Graefes Arch Clin Exp Ophthalmol 1996;234:657–658.

    Article  CAS  PubMed  Google Scholar 

  4. Park DW, Sipperley JO, Sneed SR, et al. Macular hole surgery with internal-limiting membrane peeling and intravitreous air. Ophthalmology 1999;106:1392–1398.

    Article  CAS  PubMed  Google Scholar 

  5. Merkur AB, Tuli R. Macular hole repair with limited nonsupine positioning. Retina 2007;27:365–369.

    Article  PubMed  Google Scholar 

  6. Tranos PG, Peter RN, Nath R, et al. Macular hole surgery without prone positioning. Eye 2007;21:802–806.

    Article  CAS  PubMed  Google Scholar 

  7. Rubinstein A, Ang A, Patel CK. Vitrectomy without postoperative posturing for idiopathic macular holes. Clin Experiment Ophthalmol 2007;35:458–461.

    Article  PubMed  Google Scholar 

  8. Gass JDM. Reappraisal of biomicroscopic classification of stages of development of macular hole. Am J Ophthalmol 1995;119:752–759.

    CAS  PubMed  Google Scholar 

  9. Tornambe PE, Poliner LS, Grote K. Macular hole surgery without face-down positioning. A pilot study. Retina 1997;17:179–185.

    CAS  PubMed  Google Scholar 

  10. Simcock PR, Scalia S. Phacovitrectomy without prone posture for full thickness macular holes. Br J Ophthalmol 2001;85:1316–1319.

    Article  CAS  PubMed  Google Scholar 

  11. Hasler PW, Prünte C. Early foveal recovery after macular hole surgery. Br J Ophthalmol 2008;92:645–649.

    Article  CAS  PubMed  Google Scholar 

  12. Sato Y, Isomae T. Macular hole surgery with internal limiting membrane removal, air tamponade, and 1-day prone positioning. Jpn J Ophthalmol 2003;47:503–506.

    Article  PubMed  Google Scholar 

  13. Guillaubey A, Malvitte L, Lafontaine PO, et al. Comparison of face-down and seated position after idiopathic macular hole surgery: a randomized clinical trial. Am J Ophthalmol 2008;146:128–134.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Second Department of Ophthalmology, Toho University School of Medicine, Faculty of Medicine, Tokyo, Japan

    Fumihiko Yagi, Yukihiro Sato, Seiji Takagi & Goji Tomita

  2. Department of Ophthalmology, Toho University Ohashi Medical Center, Tokyo, Japan

    Fumihiko Yagi, Seiji Takagi & Goji Tomita

  3. Department of Ophthalmology, Toho University Sakura Medical Center, Sakura, Japan

    Yukihiro Sato

  4. Second Department of Ophthalmology, Toho University School of Medicine, 2-17-6 Ohashi, Meguro-ku, Tokyo, 153-8515, Japan

    Fumihiko Yagi

Authors
  1. Fumihiko Yagi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yukihiro Sato
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Seiji Takagi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Goji Tomita
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fumihiko Yagi.

About this article

Cite this article

Yagi, F., Sato, Y., Takagi, S. et al. Idiopathic macular hole vitrectomy without postoperative face-down positioning. Jpn J Ophthalmol 53, 215–218 (2009). https://doi.org/10.1007/s10384-008-0642-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10384-008-0642-7

Key Words

Search

Navigation