Comparion of Face-Down and eated Poition After Idiopathic Macular Hole urgery: A Randomized Clinical Trial Original Reearch Article

Purpoe To compare two therapeutic modalitie on anatomic and functional reult after idiopathic macular hole (MH) urgery: eated v face-down poition. Deign Multicenter, propective, randomized trial. Method etting: Univerity Hopital Dijon and Univerity Hopital Nancy. patient: One hundred and forty-four patient (150 eye) were enrolled and randomly eparated into two group for potoperative poition: for the 72 eye in the P0 group and the 78 eye in the P1 group, the patient were aked to keep the eated (P0 group) and the face-down poition (P1 group) after the idiopathic MH urgery. intervention: All patient underwent a complete vitrectomy with a fluid-air exchange and an intraocular ga tamponade. After the urgery, patient were aked to keep one of the two randomly choen poition for five day. main outcome meaure: Bet-corrected viual acuity (VA), fundu examination, and macular optical coherence tomography were performed before and ix month after urgery. Reult The overall anatomic ucce rate wa 92.7%. The idiopathic MH ealed in 63 of 72 P0 eye (87.5%) and 76 of 78 P1 eye (97.4%) (P = .027). The mean VA increaed from 0.86 to 0.61 logMAR (0.88 to 0.61 in P0 and 0.84 to 0.60 in P1). However, in a pot hoc analyi baed on the ize of the idiopathic MH, the ucce rate in idiopathic MH maller than 400 μm wa not influenced by the potoperative poition (P = .47). Concluion A face-down potoperative poition i highly recommended in hole larger than 400 μm. The ize of the idiopathic MH eem to be an important factor affecting outcome.