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Idiopathic Macular Hole Vitrectomy Without Postoperative Face-Down Positioning Performed by Different Surgeons.

AbstractPURPOSE:
To evaluate the efficacy of vitrectomy with internal limiting membrane peeling and sulfur hexafluoride gas tamponade without postoperative face-down positioning for macular holes (MHs) when performed by 3 surgeons at 2 centers.
DESIGN:
A retrospective, consecutive, observational case series.
METHODS:
Fifty-seven eyes operated on by 1 of 3 surgeons and followed for 12 months after surgery were studied. Exclusion criteria included cases with MH duration longer than 6 months, secondary MH, and clear lenses. The surgical procedure involved cataract extraction and intraocular lens implantation in all phakic eyes before vitrectomy. Internal limiting membrane removal and 20% sulfur hexafluoride gas tamponade without postoperative face-down positioning were performed in all cases. Preoperative factors [age at surgery, sex, symptom duration, visual acuity (VA), MH size, and MH stage], initial and final hole-closure rates and VA at 1, 3, 6, and 12 months after surgery, were evaluated.
RESULTS:
Mean patient age was 65.3 years. Of the 57 eyes, 40 were in women, and 17 were in men. Macular hole (mean size, 0.30 disc diameter) was present for a mean of 2.37 months. Eight eyes had stage 2, 37 had stage 3, and 12 had stage 4 MH. Fifty-four holes (94.7%) initially closed. Final closure rate was 100%. Mean VA significantly improved from 0.65 to 0.41 at 1 month, 0.35 at 3 months, 0.28 at 6 months, and 0.21 at 12 months after surgery.
CONCLUSIONS:
Vitrectomy without face-down positioning for MHs produced favorable anatomic and functional results, regardless of which surgeon performed the procedure.
AuthorsFumihiko Yagi, Yukihiro Sato, Seiji T Takagi, Goji Tomita
JournalAsia-Pacific journal of ophthalmology (Philadelphia, Pa.) (Asia Pac J Ophthalmol (Phila)) 2013 Jan-Feb Vol. 2 Issue 1 Pg. 20-2 ISSN: 2162-0989 [Print] China
PMID26107863 (Publication Type: Journal Article)

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