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. 2020 Feb;40(2):282-289.
doi: 10.1097/IAE.0000000000002396.

NO FACE-DOWN POSITIONING SURGERY FOR THE REPAIR OF CHRONIC IDIOPATHIC MACULAR HOLES

Ebrahim S Elborgy  1 , Matthew R Starr  2 , Jacek G Kotowski  2 , Jackson E Abou Chehade  2 , Raymond Iezzi  2
Affiliations

NO FACE-DOWN POSITIONING SURGERY FOR THE REPAIR OF CHRONIC IDIOPATHIC MACULAR HOLES

Ebrahim S Elborgy et al. Retina. 2020 Feb.

Abstract

Purpose: To report visual and anatomical outcomes after the repair of chronic idiopathic macular holes (MHs) with no face-down positioning.

Methods: We conducted a retrospective review of chronic MH cases of greater than 1-year duration that were repaired through pars plana vitrectomy with broad internal limiting membrane peeling and no face-down positioning between March 2009 and December 2017. There were 18 eyes of 18 patients that met inclusion criteria. Patients with MH duration of less than 1 year and without at least 1 month of follow-up were excluded. Macular hole staging and measurements were performed with spectral domain optical coherence tomography.

Results: Mean MH duration was 5.0 ± 6.9 years. Two-thirds of MHs had a basal diameter of more than 1,000 μm. Mean preoperative Snellen visual acuity was 20/302 and improved to a mean postoperative visual acuity of 20/112 (P ≤ 0.0001). Visual acuity improved in all patients who achieved successful anatomical closure, 94.4% (17/18) of eyes.

Conclusion and relevance: Patients in this series with chronic MH who underwent no-face-down MH repair demonstrated a high single-surgery anatomical closure rate with a significant improvement in visual acuity.

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