Shortening the duration of prone positioning after macular hole surgery- comparison between 1-week and 1-day prone positioning.

PURPOSE To shorten the duration of prone positioning after macular hole surgery from 1 week to 1 day, and to evaluate preoperative factors and the initial hole closure rate. METHODS The subjects were 33 patients (34 eyes) who underwent macular hole surgery between April 1998 and August 1999, and maintained the prone position for 1 week (1-week group) and 21 patients (21 eyes) who underwent this operation between September 1999 and March 2000, and maintained the prone position for only 1 day (1-day group). The criteria for macular hole surgery were no more than 6 months since symptom development and no flattening of the fluid cuff. Eyes treated by removal of the retinal pigment epithelium (RPE) or internal limiting membrane (ILM) were excluded. In all phakic eyes, cataract surgery was combined with macular hole surgery. In the 1-day group, the patients maintained the prone position for 1 day and were instructed to avoid only the supine position for the subsequent 1 week. RESULTS Preoperative factors possibly affecting the hole closure rate did not differ significantly between the two groups. Initial hole closure rates were similar in the 1-week (91.2%) and 1-day (90.5%) groups. CONCLUSION In eyes without symptoms of long duration, the duration of prone positioning after macular hole surgery may be shortened to 1 day even without using special techniques, such as removal of the RPE or ILM, in combination with macular hole surgery.