Phacovitrectomy without prone posture for full thickness macular holes

Aims-To investigate the role of phacovitrectomy surgery without prone postu re for stage 2 and 3 macular holes. Methods-A pilot study was performed on 20 patients (20 eyes) having phacoem ulsification lens removal and vitrectomy surgery with 20% C2F6 tamponade. P atients were advised to avoid lying on their backs for 10 days following su rgery but no other posturing instructions were given. Closure rates and imp rovement in visual acuity were compared with a group of historical controls in whom phacovitrectomy with gas tamponade and face down posturing was per formed. Results-Anatomical hole closure was noted in 18 of the 20 eyes (90%). 19 ey es (95%) showed an improvement of at least 0.3 logMAR units. This compares favourably with the postured group in which anatomical hole closure was not ed in 11 of 13 eyes (85%) and nine of 13 eyes (69%) showed an improvement o f at least 0.3 logMAR units. Conclusion-Combined surgery facilitates the use of a large gas bubble. Suff icient tamponade of the hole occurs for closure without prone posturing. Co mbined surgery prevents patients posturing and returning for cataract surge ry.