Stellenwert der postoperativen positionierung in der chirurgie des idiopathischen makulaforamens - Kontrollierte konsekutive studie

Translated title of the contribution: Significance of face-down positioning after macular hole surgery with long-acting gas - Consecutive case control study

P. Szurman*, F. M. Di Tizio, B. Lafaut, S. Aisenbrey, S. Grisanti, S. Roters, K. U. Bartz-Schmidt

*Corresponding author for this work
21 Citations (Scopus)

Abstract

Background: Postoperative face-down positioning is considered to be a critical part in macular hole surgery with short-acting gas. However, the significance of this posturing remains uncertain using long-acting gas tamponade. Patients and Methods: Fifty consecutive eyes with idiopathic full-thickness macular holes underwent macular hole surgery with a follow up time of 6-12 months. The results of a cohort (25 eyes) with complete C3F8 (16 %) vitreous fill without posturing was compared to a cohort (25 eyes) with SF6 (20%) with strict postoperative face-down positioning for two weeks. Results: With SF6 tamponade the anatomic success rate was 64%, in the C3F8 cohort a complete closure was achieved in 88%. In the SF6 cohort, visual recovery of three lines or better was attained in 44%, resulting in a visual acuity of 20/50 or better in 12%. The mean postoperative visual acuity was 20/125 with a mean rise of 1.4 lines. In the C3F8 cohort, 72% improved for at least three lines with a mean postoperative visual acuity of 20/63 and a mean visual recovery of 3.3 lines. Visual acuity of 20/50 or better was noted in 48% of eyes. Conclusion: The significantly higher success rate using C3F8 tamponade without positioning compared to SF6 gas tamponade with positioning confirms the cumulative tamponade duration being a crucial factor in macular hole surgery. Using a tamponade with short-acting gas only strict postoperative positioning ensures the contact of the gas bubble with foveal tissue and gains significance with reducing bubble size. While a potential for significant visual recovery in certain cases is evident, all in all a broad variability of the postoperative success rate can be stated. In contrast, even in supine position C3F8 attains a continuous tamponade enforcing a sufficient glial wound healing without any positioning.

Translated title of the contributionSignificance of face-down positioning after macular hole surgery with long-acting gas - Consecutive case control study
Original languageGerman
JournalKlinische Monatsblatter fur Augenheilkunde
Volume217
Issue number6
Pages (from-to)351-355
Number of pages5
ISSN0023-2165
DOIs
Publication statusPublished - 2000

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