Sustained postoperative face-down positioning is unnecessary for successful macular hole surgery
Sustained postoperative face-down positioning is unnecessary for successful macular hole surgery
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DOI：
10.1136/bjo.2008.148544
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发表时间：
2009-05-01
影响因子：
4.1
通讯作者：
Pollack, J. S.
中科院分区：
文献类型：
--
作者：
Mittra, R. A.;Kim, J. E.;Pollack, J. S.
目的：确定术后 1 天俯卧位黄斑裂孔闭合成功率方法：对 15 个月内采用术后 1 天俯卧位方案进行的所有连续 3 期和 4 期黄斑裂孔手术病例进行多中心审查。白内障手术并不常规与黄斑裂孔手术相结合。除七只眼睛外，所有眼睛均采用内界膜剥离术。使用 SF6 或 C3F8 气体填充。评估的主要结果是孔闭合率。结果：确定了 53 名患者的 56 只眼睛。 79% 的眼睛患有 3 期黄斑裂孔，56 只眼睛中的 39 只 (70%) 在手术时患有晶状体眼。术前平均 logMAR 视力为 0.74（与 20/100 Snellen 相似），术后平均 logMAR 视力为 0.41（与 20/50 Snellen 相似），平均随访时间为 5.2 个月。 52只眼（93%）通过一次手术实现了黄斑裂孔闭合。结论：成功闭合黄斑裂孔可能不需要持续的术后仰卧位，因为93%的眼睛仅通过俯卧位1天就实现了裂孔闭合。
Aim: To determine the rate of successful macular hole closure with 1-day postoperative prone positioningMethods: Multicentre review of all consecutive cases of stage 3 and 4 macular hole surgery performed during a 15-month period employing 1-day postoperative face-down positioning regimen. Cataract surgery was not routinely combined with macular hole surgery. Internal limiting membrane peeling was employed in all but seven eyes. Either SF6 or C3F8 gas tamponade was used. The primary outcome assessed was the rate of hole closure.Results: 56 eyes of 53 patients were identified. 79% of eyes had stage 3 macular holes, and 39 of 56 (70%) eyes were phakic at the time of surgery. The mean preoperative logMAR vision was 0.74 (similar to 20/100 Snellen) and mean postoperative logMAR vision was 0.41 (similar to 20/50 Snellen) with a mean follow-up period of 5.2 months. Macular hole closure was achieved in 52 eyes (93%) with one operation.Conclusion: Sustained postoperative face-down positioning may not be necessary for successful macular hole closure, since 93% of eyes achieved hole closure with prone positioning for only 1 day.