Combined 23-gauge, sutureless transconjunctival vitrectomy with phacoemulsification without face down posturing for the repair of idiopathic macular holes

Heath, Gordon G.; Rahman, Rubina

doi:10.1038/eye.2009.292

Cited by 33 publications

(13 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Other surgeons have proposed that long-lasting gas be used, and face-down positioning be avoided 7,8,13. The questions of whether face-down positioning is required at all, or whether overnight positioning is sufficient, have been investigated in several studies that have resulted in success rates of 85% to 96.7% 7,8,14–17.…”

Section: Discussionmentioning

confidence: 99%

“…Combined phacovitrectomy maybe a choice for some surgeons, but this has been associated with complications such as an iris/intraocular lens capture in up to 8.6% of patients 13,31. Cataract surgery performed as a separate procedure after macular hole repair can cause complications due to intraoperative difficulties during phacoemulsification, which arise from the absence of vitreous support in a vitrectomized eye and the increased risk of zonular or posterior capsular insult 7,13. Moreover, cataract surgery following macular hole repair may lead to postoperative reopening of the macular hole in 20% of patients, especially if there are complications involving cystoid macular edema 32…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Macular hole surgery with short-acting gas and short-duration face-down positioning

Kabanarou¹,

Xirou²,

Feretis³

2012

OPTH

View full text Add to dashboard Cite

PurposeTo report on the outcomes of vitrectomy and sulfur hexafluoride (SF6) gas tamponade for idiopathic macular holes with 2 days of face-down positioning.Patients and methodsThis was a prospective, nonrandomized, observational sequential case-series study on 23 consecutive patients receiving macular hole surgery using 20% SF6 and advised to stay in a face-down position for 2 days postoperatively (SF6 group). These patients were compared to 23 consecutive patients who had previously undergone macular hole surgery, had received 14% C3F8, and were advised to maintain a face-down position for 2 days (C3F8 group). Patients in both groups underwent vitrectomy, internal limiting membrane peeling, and fluid gas exchange using either SF6 or C3F8. Preoperative and postoperative data included best corrected visual acuity recorded in LogMAR units, slit-lamp biomicroscopy, and optical coherence tomography.ResultsAt a 6-month follow-up, macular hole closure was noted in 23/23 eyes (100%) and in 22/23 eyes (96%) in the SF6 and C3F8 groups, respectively. The improvement in visual acuity (measured through Snellen acuity lines both preoperatively until 6 months postoperatively) was 4.08 ± 2.31 (95% confidence interval [CI]: 3.08–5.08) for the SF6 group and 2.87 ± 2.30 (95% CI: 1.87–3.86) for the C3F8 group; this difference was not statistically significant (P = 0.06).ConclusionVitrectomy with internal limiting membrane peeling and a short-acting gas tamponade using SF6 with posture limitation for 2 days may give a high success rate in macular hole surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Macular hole surgery with short-acting gas and short-duration face-down positioning

Kabanarou¹,

Xirou²,

Feretis³

2012

OPTH

View full text Add to dashboard Cite

show abstract

“…Primary anatomical hole closure was achieved in 96.7% eyes. In 2010, Heath and Rahman [10] reported a 92.5% success rate of 23-gauge vitrectomy with phacoemulsification without face-down posturing, using 16% C 2 F 6 gas with ILM peeling. …”

Section: Discussionmentioning

confidence: 99%

Combined Idiopathic Macular Hole Vitrectomy with Phacoemulsification without Face-Down Positioning

Yagi

Takagi

Tomita

2012

Journal of Ophthalmology

View full text Add to dashboard Cite

Purpose. To evaluate the outcome of combined vitrectomy with phacoemulsification without postoperative face-down positioning for idiopathic macular holes (MHs). Design. Retrospective, observational case series. Participants. Forty-two eyes of 42 patients with MH. Methods. We studied 42 eyes of 42 cases followed up for 6 months postoperatively. MH closure rate and preoperative and postoperative visual acuity (VA) were evaluated. Main Outcome Measures. MH closure rate and VA were evaluated after combined vitrectomy with phacoemulsification without postoperative face-down positioning. Results. Of the 42 holes, 40 (95.2%) were initially closed, and the final closure rate was 100%. Compared with preoperative VA, the mean VA was significantly improved at 1 month and the improvement was maintained for at least 6 months postoperatively. Conclusions. Combined vitrectomy with phacoemulsification without postoperative face-down positioning produced favorable anatomic and functional results for MH repair. Improvement in VA can be expected for up to at least 6 months postoperatively.

show abstract

“…These studies also focused independently on some specific issues in MHS, such as ILM peeling and C3F8 tamponade (Nadal et al. ), broad ILM peeling and 20% sulphurhexafluoride (SF6) tamponade (Iezzi & Kapoor ), or combination with phacoemulsification (Heath & Rahman ). Nevertheless, definite conclusions could not be easily drawn with individual findings.…”

Section: Introductionmentioning

confidence: 99%

Face‐down or no face‐down posturing following macular hole surgery: a meta‐analysis

Xie

Ding

et al. 2015

Acta Ophthalmologica

View full text Add to dashboard Cite

ABSTRACT.To evaluate the impact of postoperative posturing with or without face-down on the anatomical and functional outcomes of macular hole surgery. A literaturebased meta-analysis was conducted to identify studies relevant to posturing following macular hole surgery (MHS). PubMed and Web of Science databases were used to retrieve articles up to 1 June 2015. The primary measures included MH closure and ideal vision acuity improvement. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated in Review Manager. Four randomized control trials (RCTs) comprising 251 cases were included in the final meta-analysis. No face-down posturing (FDP) after MHS revealed lower anatomic success rate compared to face-down posturing (OR = 0.33, 95% CI [0.13, 0.81], p = 0.02). For holes smaller than 400 lm in size, the subgroup meta-analysis indicated no significant effect of FDP on successful hole closure (OR = 0.29, 95% CI [0.01, 7.34], p = 0.45). However, when holes were larger than 400 lm, it seemed less effective on MH closure following surgery in no FDP group (OR = 0.23, 95% CI [0.07, 0.71]), and this was statistically significant (p = 0.01). Our work found that no FDP was not inferior to its facedown counterpart for the success of MHS when macular holes were smaller than 400 lm in size. For macular holes larger than 400 lm, statistical analysis proved that FDP might be necessary. More well-conducted randomized control trials are needed to verify our findings.

show abstract

Combined 23-gauge, sutureless transconjunctival vitrectomy with phacoemulsification without face down posturing for the repair of idiopathic macular holes

Cited by 33 publications

References 30 publications

Macular hole surgery with short-acting gas and short-duration face-down positioning

Macular hole surgery with short-acting gas and short-duration face-down positioning

Combined Idiopathic Macular Hole Vitrectomy with Phacoemulsification without Face-Down Positioning

Face‐down or no face‐down posturing following macular hole surgery: a meta‐analysis

Contact Info

Product

Resources

About