Patients undergoing vitrectomy surgery for idiopathic full-thickness macular holes used to be routinely advised to follow a strict regime of posturing face down for a variable period (up to 2 weeks) after surgery. There was a scientific rationale for this-the tractional forces of gravity would force gases against the macula allowing it to heal more readily. Patients who postured were therefore believed to be less at risk of their macular hole reopening and of the need for repeat surgery to repair the hole. Medicine has clearly changed very significantly over time with a far greater emphasis on patient based outcomes and upon the need for an evidence base to justify practice.
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