Surgical Outcomes of Taking a Reading Position after Air Tamponade in Idiopathic Macular Hole

ABSTRACT

PURPOSE: In this study we compared the postoperative hole closure rate and average vision between a group who assumed a face-down position for a week using gas and a group who assumed a reading position after fluid air exchage (FAX), both after receiving internal limiting membrane (ILM) peeling during vitrectomy in patients with idiopathic macular hole. METHODS: This study included 25 eyes of patients diagnosed with idiopathic macular hole that underwent vitrectomy. Group I assumed a face-down position for a week after intraocular gas tamponade after FAX during vitrectomy and Group II assumed a reading position for 3 days after only FAX. The hole closure rate and the best-corrected visual acuity (BCVA) were compared between the 2 groups 6 months postoperatively. RESULTS: The preoperative mean macular hole size was 456.2 +/- 164.1 microm in Group I and 411.2 +/- 105.7 microm in Group II and the differences between the 2 groups were not statistically significant (p = 0.647). At 6 months after surgery, the macular hole closure rate was 93% in Group I and 100% in Group II (p = 0.571) and the BCVA (log MAR) was 0.82 +/- 0.29 preoperatively and 0.92 +/- 0.35 postoperatively in Group I and 0.71 +/- 0.39 and 0.97 +/- 0.33 in Group II, respectively. The differences between the 2 groups (p = 0.09, p = 0.058) were not statistically significant (p = 0.809, p = 0.267). CONCLUSIONS: There was no significant differences in the macular hole closure rate and BCVA improvement after 6 months in patients with idiopathic macular hole who had FAX during vitrectomy and maintained only a reading position for 3 days compared with those with gas tamponade and who maintained a face-down position for a week. This surgical method is considered helpful for easing discomfort caused by a face-down position after the macular hole surgery.