In this study we compared the postoperative hole closure rate and average vision between a group who assumed a face-down position for a week using gas and a group who assumed a reading position after fluid air exchage (FAX), both after receiving internal limiting membrane (ILM) peeling during vitrectomy in patients with idiopathic macular hole.

This study included 25 eyes of patients diagnosed with idiopathic macular hole that underwent vitrectomy. Group I assumed a face-down position for a week after intraocular gas tamponade after FAX during vitrectomy and Group II assumed a reading position for 3 days after only FAX. The hole closure rate and the best-corrected visual acuity (BCVA) were compared between the 2 groups 6 months postoperatively.

The preoperative mean macular hole size was 456.2 ± 164.1 µm in Group I and 411.2 ± 105.7 µm in Group II and the differences between the 2 groups were not statistically significant ( p = 0.647). At 6 months after surgery, the macular hole closure rate was 93% in Group I and 100% in Group II ( p = 0.571) and the BCVA (log MAR) was 0.82 ± 0.29 preoperatively and 0.92 ± 0.35 postoperatively in Group I and 0.71 ± 0.39 and 0.97 ± 0.33 in Group II, respectively. The differences between the 2 groups ( p = 0.09, p = 0.058) were not statistically significant ( p = 0.809, p = 0.267).

There was no significant differences in the macular hole closure rate and BCVA improvement after 6 months in patients with idiopathic macular hole who had FAX during vitrectomy and maintained only a reading position for 3 days compared with those with gas tamponade and who maintained a face-down position for a week. This surgical method is considered helpful for easing discomfort caused by a face-down position after the macular hole surgery.