Purpose: To determine the success of vitrectomy with ILM peeling and C(3)F(8) tamponade for macular holes without the need for postoperative face-down posturing.
Methods: Twenty-four eyes of 24 consecutive patients undergoing pars plana vitrectomy with indocyanine green-assisted ILM peeling and C(3)F(8) tamponade without prone posturing were included in the study. All patients had follow up on 1 day, 2 weeks and 3 months postoperatively. Biomicroscopy and optical coherence tomography were used to assess macular hole closure at 3 months postoperatively. Snellen visual acuity was compared pre- and postoperatively.
Results: Of the 24 eyes recruited, two (8%) had stage II, 17 (71%) had stage III and five (21%) had stage IV macular holes. Nineteen (79%) eyes were phakic and five (21%) eyes were pseudophakic at the time of surgery. The macular holes had been present for an average of 7.5 months (range 3-18 months). At 3-month follow up, 22/24 (91.6%) holes were closed. Both of the two holes that failed to close were stage IV macular holes. Preoperative visual acuity ranged from 6/18 to 6/60 (mean 6/36). Postoperative visual acuity ranged from 6/9 to 6/60 (mean 6/18). Eighteen eyes had improvement of visual acuity of at least one line on the Snellen chart, six eyes had no improvement. No eyes had worse vision postoperatively.
Conclusion: Macular hole surgery without face-down posturing provides anatomical and functional results comparable to those with prone posturing. Combined phacovitrectomy is not essential to avoid prone posturing.