To compare the anatomical and functional results of vitrectomy for macular hole with and without prone posture.

We retrospectively reviewed the medical records of 71 eyes of 71 patients who received macular hole repair and were followed up for at least 6 months. The anatomical success, complications, and best corrected visual acuity at postoperative 6 months and last follow-up between patients who were advised to take a prone posture for 1 week (group 1) and patients who were advised to simply avoid the supine position right from the surgery (group 2) were analyzed. Subgroup division analysis according to macular hole size and concurrent phacoemulsification was performed.

Macular hole closure rate was 91.7% (33 of 36 eyes) in group 1 and 88.6% (31 of 35 eyes) in group 2 ( p =0.710). The mean visual acuity at final follow-up increased in both groups by 4.75 ± 3.83 and 4.76 ± 2.96 lines, respectively and revealed no statistically significant difference ( p = 0.988). Twenty-seven of 36 eyes (75%) in group 1 and 30 of 35 eyes (85.7%) in group 2 underwent concurrent phacoemulsification, and no difference in macular hole closure rate and visual acuity improvement between the two postures was observed.

Favorable anatomical and functional outcomes were achieved without postoperative face-down posturing in the case of phacovitrectomy with wide internal limiting membrane peeling and gas tamponade.