Krohn Jørgen
Department of Ophthalmology, University of Bergen, Bergen, Norway.
Acta Ophthalmol Scand. 2005 Jun;83(3):289-92. doi: 10.1111/j.1600-0420.2005.00462.x.
To investigate whether shortening the duration of face-down positioning from 1 week to 3 days affects the anatomical success rate of macular hole surgery.
A total of 53 consecutive eyes in 50 patients with full thickness macular holes of 2-24 months' (average 10 months) duration were included in the study. In 20 eyes (37.7%) the hole had been present for more than 1 year. All patients were operated with vitrectomy, removal of the posterior hyaloid and a complete fluid-gas exchange. Peeling of the internal limiting membrane (ILM) was not performed. Postoperatively, the duration of face-down positioning differed between two consecutive groups of patients. The first group (29 patients) was instructed to keep their heads face-down for 7 days, while the second group (24 patients) maintained face-down positioning for only 3 days.
Overall, 90.6% of the macular holes closed with one operation. The macular hole closed successfully in 27 (93.1%) of the 29 eyes in the 1-week group and in 21 (87.5%) of the 24 eyes in the 3-day group (p > 0.05).
Although the frequency of hole closure differed slightly in the two study groups, the difference was far from statistically significant. Thus, the results indicate that 3 days of strict face-down positioning are sufficient to achieve closure of even longstanding macular holes without removal of the ILM.
探讨将面朝下体位的持续时间从1周缩短至3天是否会影响黄斑裂孔手术的解剖学成功率。
本研究纳入了50例全层黄斑裂孔患者的53只连续眼，裂孔持续时间为2 - 24个月（平均10个月）。其中20只眼（37.7%）的裂孔存在时间超过1年。所有患者均接受玻璃体切除术、后玻璃体膜切除及完全的液 - 气交换。未进行内界膜（ILM）剥除。术后，两组连续患者的面朝下体位持续时间不同。第一组（29例患者）被要求头部面朝下保持7天，而第二组（24例患者）仅保持面朝下体位3天。
总体而言，90.6%的黄斑裂孔一次手术即闭合。1周组29只眼中27只（93.1%）黄斑裂孔成功闭合，3天组24只眼中21只（87.5%）成功闭合（p > 0.05）。
尽管两个研究组裂孔闭合的频率略有差异，但差异远未达到统计学显著水平。因此，结果表明3天严格的面朝下体位足以实现即使是长期存在的黄斑裂孔的闭合，而无需进行内界膜剥除。
