Alberti Mark, la Cour Morten
Department of Ophthalmology, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark.
Br J Ophthalmol. 2015 Feb;99(2):236-9. doi: 10.1136/bjophthalmol-2014-305569. Epub 2014 Aug 21.
To evaluate the full thickness macular hole (FTMH) closure rate in patients positioning non-supine (NSP) compared with patients positioning face-down (FDP).
We retrospectively reviewed two FTMH case series-postoperative positioning was FDP and NSP, respectively. All eyes were pseudophakic and treatment consisted of pars plana vitrectomy, internal limiting membrane peeling and perfluoropropane gas tamponade. Primary outcome measure was FTMH closure verified by optical coherence tomography. Secondary outcome was ETDRS visual acuity 6 months postoperatively.
Over 13.7 months 122 eyes were included in this study, 66 eyes in the FDP group and 56 eyes in the NSP group. Closure rates were 95.5% and 96.4% in the FDP group and the NSP group, respectively. Median postoperative visual acuity at 6 months was 69 ETDRS letters in both positioning groups (p=0.64). Neither positioning group fully complied with the recommended positioning protocol.
Results from consistent FTMH repair indicate similar anatomical success rates in FDP and NSP groups, suggesting that FDP is unnecessary. Objective monitoring of positioning would be beneficial in future FTMH studies to be able to adjust for positioning protocol compliance.
评估非仰卧位（NSP）患者与面朝下体位（FDP）患者的全层黄斑裂孔（FTMH）闭合率。
我们回顾性分析了两个FTMH病例系列——术后体位分别为FDP和NSP。所有患眼均为人工晶状体眼，治疗包括玻璃体切割术、内界膜剥除术和全氟丙烷气体填塞。主要观察指标是通过光学相干断层扫描证实的FTMH闭合情况。次要观察指标是术后6个月的ETDRS视力。
在13.7个月的时间里，本研究共纳入122只眼，其中FDP组66只眼，NSP组56只眼。FDP组和NSP组的闭合率分别为95.5%和96.4%。两个体位组术后6个月的视力中位数均为69个ETDRS字母（p = 0.64）。两个体位组均未完全遵守推荐的体位方案。
FTMH修复的一致性结果表明，FDP组和NSP组的解剖学成功率相似，这表明FDP体位并非必要。在未来的FTMH研究中，对体位进行客观监测将有助于根据体位方案的依从性进行调整。
