Document Detail


INDIVIDUALIZED, SPECTRAL DOMAIN-OPTICAL COHERENCE TOMOGRAPHY-GUIDED FACEDOWN POSTURING AFTER MACULAR HOLE SURGERY: Minimizing Treatment Burden and Maximizing Outcome.
MedLine Citation:
PMID:  24955569     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE: To evaluate the individualized, optical coherence tomography-guided facedown posturing after macular hole (MH) surgery in minimizing the burden and maximizing outcome.
METHODS: A retrospective comparative study. One hundred and seven consecutive eyes with an MH (<500 μm) received vitrectomy and gas tamponade. After surgery, optical coherence tomography examination was performed from 6 hours to postoperative Day 2. In Group A, with a pro re nata posturing protocol, the duration of facedown posturing was determined from the optical coherence tomography findings. Group A was subdivided as follows: Group A1, facedown posturing required postoperatively and Group A2, no posturing required. When MH closure was confirmed, facedown posturing (if any) was discontinued. If the MH did not close, additional posturing was advised. Group B was the control group, consisted of 42 consecutive eyes with traditional 7 days of posturing.
RESULTS: After a single surgery, Group A had the MH closure rate of 96.2%, 95.8% in Group A1 and 97.1% in Group A2, whereas Group B had the MH closure rate of 95.2%. The average posturing period was 42 hours for Group A, 57 hours for Group A1 and 10 hours for Group A2 (P < 0.001). The MH size was correlated significantly with the closure time (R = 0.47, P = 0.005, Spearman correlation coefficient).
CONCLUSION: A pro re nata posturing protocol achieves a high MH closure rate with a significant reduction of posturing time especially for pseudophakic eyes.
Authors:
Toshifumi Yamashita; Taiji Sakamoto; Takehiro Yamashita; Shozo Sonoda; Keita Yamakiri; Hiroki Otsuka; Toshio Hisatomi; Hiroyuki Imaki; Tatsuro Ishibashi; Pravin U Dugel
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Retina (Philadelphia, Pa.)     Volume:  34     ISSN:  1539-2864     ISO Abbreviation:  Retina (Philadelphia, Pa.)     Publication Date:  2014 Jul 
Date Detail:
Created Date:  2014-06-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309919     Medline TA:  Retina     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1367-75     Citation Subset:  IM    
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