Lindtjørn Birger, Krohn Jørgen, Austeng Dordi, Fossen Kristian, Varhaug Pål, Basit Sammy, Helgesen Ole H, Eide Geir E, Forsaa Vegard A
Department of Ophthalmology, Stavanger University Hospital, Stavanger, Norway.
Department of Clinical Medicine, Section of Ophthalmology, University of Bergen, Bergen, Norway; Department of Ophthalmology, Haukeland University Hospital, Bergen, Norway.
Ophthalmol Retina. 2019 May;3(5):388-392. doi: 10.1016/j.oret.2018.12.006. Epub 2018 Dec 31.
To evaluate the postoperative closure rate of full-thickness macular holes (MHs) after nonsupine positioning, which means that the patients avoid upward gaze and a supine sleeping position, and to investigate the correlation between postoperative positioning compliance and closure rate.
Prospective, multicenter study (ClinicalTrials.gov identifier, NCT02295943).
Patients undergoing primary surgery for primary MH.
Patients underwent pars plana vitrectomy with internal limiting membrane peeling and sulfur hexafluoride gas tamponade followed by 3 to 5 days of nonsupine positioning. A positioning measuring device that recorded the time spent in the supine position was attached to patients' forehead after surgery for 24 hours.
Anatomic closure rate of MH at 2 weeks or more after surgery and the time spent in supine position during the first 24 hours after surgery.
A total of 205 participants were included, of whom 2 were lost to follow-up. Two hundred two of 203 MHs closed after a single operation, giving a closure rate of 99.5% (95% confidence interval, 97.3%-99.9%). The median time of supine positioning during the first 24 hours was 28 seconds (range, 0:00:00-01:52:28). Because of the very high closure rate, a correlation between positioning compliance and closure rate could not be established.
Pars plana vitrectomy with internal limiting membrane peeling followed by a short-term nonsupine positioning accomplished a very high MH closure rate. Thus, face-down positioning was not necessary to achieve excellent closure rates in this study.
评估非仰卧位（即患者避免向上注视和仰卧睡眠姿势）后全层黄斑裂孔（MHs）的术后闭合率，并研究术后体位依从性与闭合率之间的相关性。
前瞻性多中心研究（ClinicalTrials.gov标识符，NCT02295943）。
接受原发性MH初次手术的患者。
患者接受玻璃体切割联合内界膜剥除及六氟化硫气体填充，随后进行3至5天的非仰卧位。术后在患者额头佩戴一个记录仰卧位时间的体位测量装置24小时。
术后2周或更长时间时MH的解剖闭合率以及术后最初24小时内的仰卧位时间。
共纳入205名参与者，其中2名失访。203个MH中有202个在单次手术后闭合，闭合率为99.5%（95%置信区间，97.3%-99.9%）。术后最初24小时内仰卧位的中位时间为28秒（范围，0:00:00-01:52:28）。由于闭合率非常高，无法确定体位依从性与闭合率之间的相关性。
玻璃体切割联合内界膜剥除并短期非仰卧位可实现非常高的MH闭合率。因此，在本研究中，无需面朝下体位即可获得优异的闭合率。
