Face down posturing makes no difference in recovery following macular hole surgery, Australia’s Associate Professor Alex Hunyor has told delegates at the American Society of Retina Specialists annual meeting in San Diego. He said “the holes with longer duration and larger size holes, as has been found in other studies, negatively correlated with success, whereas Internal Limiting Membrane peeling was strongly positively correlated with success.”
A/Prof. Hunyor cited findings from the Australian Macular Hole Study, of which he is a principal investigator. He and colleagues analysed data from the first 400 cases entered in Australia’s registry of patients undergoing macular hole repair. The cases had been treated by 48 surgeons using a variety of positioning protocols. A/Prof. Hunyor and colleagues determined outcomes from no posturing were noninferior to outcomes from face-down posturing.
Noninferiority was qualified as “not less than 90 per cent hole closure rate”. This assumed a standard hole closure rate of 95 per cent.
A/Prof Hunyor acknowledged that in the early stages of gathering data for the registry of patients undergoing macular hole repair, details of the hole size were not included. However he said hole closure data was now available on 1,820 patients, which equates to 90 per cent of the intended registry and only cases with complete data had been included in his presentation to Retina Specialists.
He said 80 per cent of cases were performed with some variation of face-down posturing, but so far in 2014, that percentage was only 60 per cent. Primary hole closure has been achieved in 95 per cent of patients, regardless of positioning.