Surgery for full-thickness macular holes with short-duration prone posturing: results of a pilot study

Purpose To see whether surgical success and complication rates in surgery f or full-thickness macular holes (FTMH) followed by 5 days prone posturing a re comparable to those obtained with longer posturing regimes recorded in t he literature. Methods A pilot study was carried out of pars plana vitrectomy, autologous platelet adjunct and 16% C2F6 tamponade followed by 5 days prone posturing in 38 eyes of 34 patients with idiopathic FTMH. A follow-up postal question naire was used to assess patients' perception of posturing and outcome. Results Fifty-three per cent of eyes gained 2 or more lines of Snellen acui ty. Twenty-four per cent of patients with symptom duration of 12 months or less (29 patients) achieved a visual acuity of 6/12. Fifty-eight per cent o f patients achieved N8 or better near vision. The only significant predicto r of post-operative Snellen acuity was the stage of the hole (p = 0.02). Ei ghty-six per cent of questionnaire respondents felt that surgery had improv ed their quality of life. Eighty-seven per cent of all patients reported a reduction in, or elimination of, metamorphopsia. Fifty-four per cent of pat ients described posturing for 5 days as difficult or very difficult. Five p atients admitted to posturing for less than 12 h a day, but all stated that they had postured for the full 5 days. Cataract was the commonest complica tion observed in this series (42% of patients have had or been listed for c ataract surgery). Conclusions Five days of prone posturing following vitrectomy for FTMH with autologous plaletet concentrate and C2F6 tamponade afforded success and co mplication rates comparable to those in published studies with longer postu ring times.