Macular hole repair without face-down positioning

摘要

Pursuant to the first publication on surgical macular hole (MH) repair in 1991, prone postoperative positioning for a variable amount of time has been adopted as standard practice. In that landmark study, Kelly and Wendel achieved a 58% success rate with vitrectomy, membrane peeling, fluid-air exchange, a nonexpansile concentration of sulfur hexafluoride gas, and 1 week of face-down positioning (FDP). Since that time there has been considerable progress in surgical techniques and equipment, ocular coherence tomography (OCT) visualization, as well as advancement of the knowledge base that has helped improve the single surgery success rate. However, there continues to be disagreement over certain aspects of MH repair including internal limiting membrane (ILM) peeling, type of stain utilized, the need for combined phacoemulsification, air or gas tamponade, and the duration and/or necessity of FDP after surgery.