Postoperative Positioning After Surgery for Macular Holes

A Randomized Clinical Trial of Face-down Protocol Versus Non-face-down Protocol After Surgery for Macular Holes.

Idiopathic macular holes are an important cause of visual loss. Macular holes can be treated by surgically removing the vitreous gel and injecting intraocular gas. Following macular hole surgery, face-down positioning is often advised with the aim of improving the likelihood of macular hole closure. The current evidence of postoperative positioning protocols is insufficient to draw firm conclusions and guide practice. The investigators wish to compare non-face-down positioning and face-down positioning after surgery for macular holes in a randomized trial.

Hypothesis: Non-face-down positioning is equivalent to face-down positioning after surgery for macular holes.

Inclusion Criteria:

• Idiopathic macular hole stage II-IV
• Informed consent
• Duration of symptoms ≤ 24 months

Exclusion Criteria:

• Previous vitreomacular surgery
• Myopia ≥ 8 diopters
• Ocular trauma
• Disease affecting visual function (proliferative diabetic retinopathy, diabetic macular edema, exudative macular degeneration)