• DOI:10.1097/IAE.0000000000000087
• Corpus ID: 20613600

INDIVIDUALIZED, SPECTRAL DOMAIN-OPTICAL COHERENCE TOMOGRAPHY–GUIDED FACEDOWN POSTURING AFTER MACULAR HOLE SURGERY: Minimizing Treatment Burden and Maximizing Outcome

@article{Yamashita2014INDIVIDUALIZEDSD,
  title={INDIVIDUALIZED, SPECTRAL DOMAIN-OPTICAL COHERENCE TOMOGRAPHY–GUIDED FACEDOWN POSTURING AFTER MACULAR HOLE SURGERY: Minimizing Treatment Burden and Maximizing Outcome},
  author={Toshifumi Yamashita and Taiji Sakamoto and Takehiro Yamashita and Shozo Sonoda and Keita Yamakiri and Hiroki Otsuka and Toshio Hisatomi and Hiroyuki Imaki and Tatsuro Ishibashi and Pravin U. Dugel},
  journal={Retina},
  year={2014},
  volume={34},
  pages={1367–1375}
}

• Toshifumi Yamashita, T. Sakamoto, +7 authors P. Dugel
• Published 1 July 2014
• Medicine
• Retina

Purpose: To evaluate the individualized, optical coherence tomography-guided facedown posturing after macular hole (MH) surgery in minimizing the burden and maximizing outcome. Methods: A retrospective comparative study. One hundred and seven consecutive eyes with an MH (<500 &mgr;m) received vitrectomy and gas tamponade. After surgery, optical coherence tomography examination was performed from 6 hours to postoperative Day 2. In Group A, with a pro re nata posturing protocol, the duration of facedown posturing was determined from the optical coherence tomography findings. Group A was subdivided as follows: Group A1, facedown posturing required postoperatively and Group A2, no posturing required. When MH closure was confirmed, facedown posturing (if any) was discontinued. If the MH did not close, additional posturing was advised. Group B was the control group, consisted of 42 consecutive eyes with traditional 7 days of posturing. Results: After a single surgery, Group A had the MH closure rate of 96.2%, 95.8% in Group A1 and 97.1% in Group A2, whereas Group B had the MH closure rate of 95.2%. The average posturing period was 42 hours for Group A, 57 hours for Group A1 and 10 hours for Group A2 (P < 0.001). The MH size was correlated significantly with the closure time (R = 0.47, P = 0.005, Spearman correlation coefficient). Conclusion: A pro re nata posturing protocol achieves a high MH closure rate with a significant reduction of posturing time especially for pseudophakic eyes.