A comparison of face-down positioning with adjustable positioning for closure rates in macular hole surgery

Objective To compare face-down positioning with adjustable positioning for closure rates and postoperative comfort of patients after full-thickness macular hole surgery, and determine whether adjustable positioning is noninferior to face-down positioning. Methods One hundred and thirty-eight cases (153 eyes) were observed from November 2014 to October 2016. All the cases were diagnosed with idiopathic macular hole, and underwent Pars Plana Vitrectomy with the Peeling of the Internal Limiting Membrane and Gas Tamponade. The intraocular pressure, closure rates of Macular holes, and best-corrected visual acuity (BCVA) were measured before and after operation. The comfort level of patients was also evaluated at day 7 after surgery. All data were analyzed by statistical analysis. Results Sixty-four cases (71 eyes) in group A and fifty-nine cases (63 eyes) in group B appeared high intraocular pressure, and three cases (3 eyes) in group A and two cases (2 eyes) in group B appeared low intraocular pressure. Final analysis of all participants demonstrated equal closure rates in both groups (P >0.05). The change of BCVA did not differ significantly between the two groups (P >0.05). The comfort level of patients had significant difference between both groups (P <0.01). Conclusions Adjustable positioning is noninferior to face-down positioning in closure rates of macular holes and BCVA of patients after surgery, when intraocular pressure of visual acuity of patients after surgery, when intraocular pressure of patients is normal or slightly higher. However, the patients with adjustable positioning show more comfortable compared to those patients with face-down positioning. Key words: Idiopathic macular hole; Face-down positioning; Adjustable positioning; Closure rates; comfort