A personalized protocol with a shorter duration of posturing after vitrectomy yielded a high rate of macular hole closure, especially in pseudophakic eyes, according to study findings.
“The overall success rate of macular hole closure with pro re nata posturing was comparable with that of the traditional 7 days of prone positioning. This suggests that immediate posturing after surgery is not required, and posturing may be imposed when needed as determined by the [spectral-domain optical coherence tomography] images,” the authors wrote.
The retrospective, comparative study included 107 eyes with macular holes that underwent vitrectomy and gas tamponade. Patients underwent OCT examination 6 hours to 2 days after surgery.
The study group (A) comprised 107 patients assigned to pro re nata posturing. A control group (B) comprised 42 patients assigned to 7 days of prone posturing.
Group A was subdivided into two groups. Group A1 comprised 72 eyes of 72 patients who assumed a face-down posture after surgery. Group A2 comprised 35 eyes of 32 patients who were directed not to assume a face-down posture.
Macular hole closure rates were 96.2% for Group A, 95.8% in Group A1, 97.1% in Group A2 and 95.2% for Group B.
Average posturing periods were 42 hours for Group A, 57 hours for Group A1 and 10 hours for Group A2 (P < .001). Macular hole size was significantly associated with closure time in Group A2 (P = .005), according to the researchers.
Disclosure: The authors have no relevant financial disclosures.