Individualized, spectral domain-optical coherence tomography-guided facedown posturing after macular hole surgery

Minimizing treatment burden and maximizing outcome

Toshifumi Yamashita, Taiji Sakamoto, Takehiro Yamashita, Shozo Sonoda, Keita Yamakiri, Hiroki Otsuka, Toshio Hisatomi, Hiroyuki Imaki, Tatsuro Ishibashi, Pravin U. Dugel

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

PURPOSE: To evaluate the individualized, optical coherence tomography-guided facedown posturing after macular hole (MH) surgery in minimizing the burden and maximizing outcome. METHODS: A retrospective comparative study. One hundred and seven consecutive eyes with an MH (<500 μm) received vitrectomy and gas tamponade. After surgery, optical coherence tomography examination was performed from 6 hours to postoperative Day 2. In Group A, with a pro re nata posturing protocol, the duration of facedown posturing was determined from the optical coherence tomography findings. Group A was subdivided as follows: Group A1, facedown posturing required postoperatively and Group A2, no posturing required. When MH closure was confirmed, facedown posturing (if any) was discontinued. If the MH did not close, additional posturing was advised. Group B was the control group, consisted of 42 consecutive eyes with traditional 7 days of posturing. RESULTS: After a single surgery, Group A had the MH closure rate of 96.2%, 95.8% in Group A1 and 97.1% in Group A2, whereas Group B had the MH closure rate of 95.2%. The average posturing period was 42 hours for Group A, 57 hours for Group A1 and 10 hours for Group A2 (P < 0.001). The MH size was correlated significantly with the closure time (R = 0.47, P = 0.005, Spearman correlation coefficient). CONCLUSION: A pro re nata posturing protocol achieves a high MH closure rate with a significant reduction of posturing time especially for pseudophakic eyes.

Original languageEnglish
Pages (from-to)1367-1375
Number of pages9
JournalRetina
Volume34
Issue number7
DOIs
Publication statusPublished - Jan 1 2014

Fingerprint

Retinal Perforations
Optical Coherence Tomography
varespladib methyl
Vitrectomy
Retrospective Studies
Gases
Control Groups

All Science Journal Classification (ASJC) codes

  • Ophthalmology

Cite this

Individualized, spectral domain-optical coherence tomography-guided facedown posturing after macular hole surgery : Minimizing treatment burden and maximizing outcome. / Yamashita, Toshifumi; Sakamoto, Taiji; Yamashita, Takehiro; Sonoda, Shozo; Yamakiri, Keita; Otsuka, Hiroki; Hisatomi, Toshio; Imaki, Hiroyuki; Ishibashi, Tatsuro; Dugel, Pravin U.

In: Retina, Vol. 34, No. 7, 01.01.2014, p. 1367-1375.

Research output: Contribution to journalArticle

Yamashita, T, Sakamoto, T, Yamashita, T, Sonoda, S, Yamakiri, K, Otsuka, H, Hisatomi, T, Imaki, H, Ishibashi, T & Dugel, PU 2014, 'Individualized, spectral domain-optical coherence tomography-guided facedown posturing after macular hole surgery: Minimizing treatment burden and maximizing outcome', Retina, vol. 34, no. 7, pp. 1367-1375. https://doi.org/10.1097/IAE.0000000000000087
Yamashita, Toshifumi ; Sakamoto, Taiji ; Yamashita, Takehiro ; Sonoda, Shozo ; Yamakiri, Keita ; Otsuka, Hiroki ; Hisatomi, Toshio ; Imaki, Hiroyuki ; Ishibashi, Tatsuro ; Dugel, Pravin U. / Individualized, spectral domain-optical coherence tomography-guided facedown posturing after macular hole surgery : Minimizing treatment burden and maximizing outcome. In: Retina. 2014 ; Vol. 34, No. 7. pp. 1367-1375.
@article{d50b82b30d5845b1b8d38fab90fc4ad2,
title = "Individualized, spectral domain-optical coherence tomography-guided facedown posturing after macular hole surgery: Minimizing treatment burden and maximizing outcome",
abstract = "PURPOSE: To evaluate the individualized, optical coherence tomography-guided facedown posturing after macular hole (MH) surgery in minimizing the burden and maximizing outcome. METHODS: A retrospective comparative study. One hundred and seven consecutive eyes with an MH (<500 μm) received vitrectomy and gas tamponade. After surgery, optical coherence tomography examination was performed from 6 hours to postoperative Day 2. In Group A, with a pro re nata posturing protocol, the duration of facedown posturing was determined from the optical coherence tomography findings. Group A was subdivided as follows: Group A1, facedown posturing required postoperatively and Group A2, no posturing required. When MH closure was confirmed, facedown posturing (if any) was discontinued. If the MH did not close, additional posturing was advised. Group B was the control group, consisted of 42 consecutive eyes with traditional 7 days of posturing. RESULTS: After a single surgery, Group A had the MH closure rate of 96.2{\%}, 95.8{\%} in Group A1 and 97.1{\%} in Group A2, whereas Group B had the MH closure rate of 95.2{\%}. The average posturing period was 42 hours for Group A, 57 hours for Group A1 and 10 hours for Group A2 (P < 0.001). The MH size was correlated significantly with the closure time (R = 0.47, P = 0.005, Spearman correlation coefficient). CONCLUSION: A pro re nata posturing protocol achieves a high MH closure rate with a significant reduction of posturing time especially for pseudophakic eyes.",
author = "Toshifumi Yamashita and Taiji Sakamoto and Takehiro Yamashita and Shozo Sonoda and Keita Yamakiri and Hiroki Otsuka and Toshio Hisatomi and Hiroyuki Imaki and Tatsuro Ishibashi and Dugel, {Pravin U.}",
year = "2014",
month = "1",
day = "1",
doi = "10.1097/IAE.0000000000000087",
language = "English",
volume = "34",
pages = "1367--1375",
journal = "Retina",
issn = "0275-004X",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

TY - JOUR

T1 - Individualized, spectral domain-optical coherence tomography-guided facedown posturing after macular hole surgery

T2 - Minimizing treatment burden and maximizing outcome

AU - Yamashita, Toshifumi

AU - Sakamoto, Taiji

AU - Yamashita, Takehiro

AU - Sonoda, Shozo

AU - Yamakiri, Keita

AU - Otsuka, Hiroki

AU - Hisatomi, Toshio

AU - Imaki, Hiroyuki

AU - Ishibashi, Tatsuro

AU - Dugel, Pravin U.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - PURPOSE: To evaluate the individualized, optical coherence tomography-guided facedown posturing after macular hole (MH) surgery in minimizing the burden and maximizing outcome. METHODS: A retrospective comparative study. One hundred and seven consecutive eyes with an MH (<500 μm) received vitrectomy and gas tamponade. After surgery, optical coherence tomography examination was performed from 6 hours to postoperative Day 2. In Group A, with a pro re nata posturing protocol, the duration of facedown posturing was determined from the optical coherence tomography findings. Group A was subdivided as follows: Group A1, facedown posturing required postoperatively and Group A2, no posturing required. When MH closure was confirmed, facedown posturing (if any) was discontinued. If the MH did not close, additional posturing was advised. Group B was the control group, consisted of 42 consecutive eyes with traditional 7 days of posturing. RESULTS: After a single surgery, Group A had the MH closure rate of 96.2%, 95.8% in Group A1 and 97.1% in Group A2, whereas Group B had the MH closure rate of 95.2%. The average posturing period was 42 hours for Group A, 57 hours for Group A1 and 10 hours for Group A2 (P < 0.001). The MH size was correlated significantly with the closure time (R = 0.47, P = 0.005, Spearman correlation coefficient). CONCLUSION: A pro re nata posturing protocol achieves a high MH closure rate with a significant reduction of posturing time especially for pseudophakic eyes.

AB - PURPOSE: To evaluate the individualized, optical coherence tomography-guided facedown posturing after macular hole (MH) surgery in minimizing the burden and maximizing outcome. METHODS: A retrospective comparative study. One hundred and seven consecutive eyes with an MH (<500 μm) received vitrectomy and gas tamponade. After surgery, optical coherence tomography examination was performed from 6 hours to postoperative Day 2. In Group A, with a pro re nata posturing protocol, the duration of facedown posturing was determined from the optical coherence tomography findings. Group A was subdivided as follows: Group A1, facedown posturing required postoperatively and Group A2, no posturing required. When MH closure was confirmed, facedown posturing (if any) was discontinued. If the MH did not close, additional posturing was advised. Group B was the control group, consisted of 42 consecutive eyes with traditional 7 days of posturing. RESULTS: After a single surgery, Group A had the MH closure rate of 96.2%, 95.8% in Group A1 and 97.1% in Group A2, whereas Group B had the MH closure rate of 95.2%. The average posturing period was 42 hours for Group A, 57 hours for Group A1 and 10 hours for Group A2 (P < 0.001). The MH size was correlated significantly with the closure time (R = 0.47, P = 0.005, Spearman correlation coefficient). CONCLUSION: A pro re nata posturing protocol achieves a high MH closure rate with a significant reduction of posturing time especially for pseudophakic eyes.

UR - http://www.scopus.com/inward/record.url?scp=84903135084&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84903135084&partnerID=8YFLogxK

U2 - 10.1097/IAE.0000000000000087

DO - 10.1097/IAE.0000000000000087

M3 - Article

VL - 34

SP - 1367

EP - 1375

JO - Retina

JF - Retina

SN - 0275-004X

IS - 7

ER -