Shimada Yoshiaki, Seno Yui, Mizuguchi Tadashi, Tanikawa Atsuhiro, Horiguchi Masayuki
Department of Ophthalmology, Fujita Health University Hospital, Aichi, Japan.
Clin Ophthalmol. 2017 Jun 8;11:1099-1104. doi: 10.2147/OPTH.S135144. eCollection 2017.
To determine adherence to face-down positioning (FDP) among patients who underwent vitrectomy and gas tamponade for macular hole (MH) repair.
A total of 69 patients (37 females and 32 males) who underwent primary vitrectomy for MH repair were studied. Nurses recorded whether the patient complied with FDP each time they examined the patient. FDP score was obtained from the nursing records; patients were given a score of 1 if they complied with the FDP and 0 if they did not. The score was recorded four times per day for the first 3 postoperative days. A perfect FDP score was 12.
The mean ± standard deviation of the FDP scores was 10.6±1.8 (range: 4-12). Overall, 32 (46.4%) patients scored a perfect 12, and 7 (10.1%) patients scored <8. Failure of the MH closure was observed in only one patient (1.4%), who showed the poorest adherence to FDP (score =4). Consequently, the closure rate in patients with FDP score <7 (2/3, 66.7%) was significantly lower than in patients with an FDP score ≥7 (66/66, 100%) (<0.05, Fisher's exact probability test).
While adherence to FDP after MH surgery was better than that observed after vitrectomy for rhegmatogenous retinal detachments in our previous study, the percentage of patients with FDP scores <8 did not differ. Statistically, the poor adherence to FDP can negatively impact the effectiveness of the surgery for MH repair.
确定接受玻璃体切除术联合气体填充治疗黄斑裂孔（MH）修复的患者对俯卧位的依从性。
对69例接受初次玻璃体切除术修复MH的患者（37例女性和32例男性）进行研究。护士每次检查患者时记录患者是否遵守俯卧位。从护理记录中获取俯卧位评分；如果患者遵守俯卧位则得1分，不遵守则得0分。术后第1个3天每天记录4次评分。完美的俯卧位评分为12分。
俯卧位评分的平均值±标准差为10.6±1.8（范围：4 - 12）。总体而言，32例（46.4%）患者获得了完美的12分，7例（10.1%）患者评分<8分。仅1例患者（1.4%）观察到MH闭合失败，该患者对俯卧位的依从性最差（评分 = 4）。因此，俯卧位评分<7分的患者闭合率（2/3，66.7%）显著低于俯卧位评分≥7分的患者（66/66，100%）（<0.05，Fisher精确概率检验）。
虽然MH手术后对俯卧位的依从性优于我们之前研究中视网膜脱离玻璃体切除术后的情况，但俯卧位评分<8分的患者百分比没有差异。从统计学上看，对俯卧位的依从性差会对MH修复手术的效果产生负面影响。
