Document Detail

Optical coherence tomography-guided facedown positioning for macular hole surgery.
MedLine Citation:
PMID:  23343822     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To use spectral domain optical coherence tomography-guided duration of facedown positioning to study anatomical macular hole closure rates.
METHODS: Retrospective review of patients with macular holes undergoing 23-gauge pars plana vitrectomy and intraocular gas tamponade. Spectral domain optical coherence tomography imaging was done on postoperative Day 1. Patients remained facedown for 2 more days if the macular hole was closed or 6 more days facedown if the macular hole was open or indeterminate.
RESULTS: There were 8 Stage 2, 12 Stage 3, and 12 Stage 4 macular holes. On postoperative Day 1, 24 holes were closed by spectral domain optical coherence tomography and instructed to remain facedown for two more days. Twenty-three of 24 holes remained closed during the postoperative period. Eight holes were open or indeterminate on postoperative Day 1 and remained facedown for 6 more days. Six of 8 holes (75%) were closed at their last follow-up. The overall closure rate was 29/32 (90.6%). Average follow-up was 334 days.
CONCLUSION: Confirming early closure of macular holes with spectral domain optical coherence tomography imaging can serve as an important guide to significantly shorten the duration of prone positioning while maintaining high closure rates.
Sumit P Shah; Varsha Manjunath; Adam H Rogers; Caroline R Baumal; Elias Reichel; Jay S Duker
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Retina (Philadelphia, Pa.)     Volume:  33     ISSN:  1539-2864     ISO Abbreviation:  Retina (Philadelphia, Pa.)     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-24     Completed Date:  2013-05-09     Revised Date:  2013-09-03    
Medline Journal Info:
Nlm Unique ID:  8309919     Medline TA:  Retina     Country:  United States    
Other Details:
Languages:  eng     Pagination:  356-62     Citation Subset:  IM    
New England Eye Center, Tufts Medical Center, Boston, Massachusetts, USA.
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MeSH Terms
Aged, 80 and over
Fluorocarbons / administration & dosage
Follow-Up Studies
Middle Aged
Patient Positioning
Prone Position*
Retinal Perforations / diagnosis*,  physiopathology,  surgery*
Retrospective Studies
Sulfur Hexafluoride / administration & dosage
Tomography, Optical Coherence*
Wound Healing / physiology
Grant Support
R01 EY011289/EY/NEI NIH HHS; R01-EY103516-07/EY/NEI NIH HHS; R01-EY11289-24/EY/NEI NIH HHS; R01-EY13178-01/EY/NEI NIH HHS
Reg. No./Substance:
0/Fluorocarbons; 2551-62-4/Sulfur Hexafluoride; 76-19-7/perflutren

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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