Comparison of Face-Down and Seated Position After Idiopathic Macular Hole Surgery: A Randomized Clinical Trial

Autor: Nicolas Jay, Alain M. Bron, Alexandre Guillaubey, Catherine Creuzot-Garcher, Jean Paul Berrod, Pierre-Olivier Lafontaine, Isabelle Hubert, L. Malvitte
Přispěvatelé: Service d'Ophtalmologie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Knowledge representation, reasonning (ORPAILLEUR), Inria Nancy - Grand Est, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Department of Natural Language Processing & Knowledge Discovery (LORIA - NLPKD), Laboratoire Lorrain de Recherche en Informatique et ses Applications (LORIA), Institut National de Recherche en Informatique et en Automatique (Inria)-Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche en Informatique et en Automatique (Inria)-Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire Lorrain de Recherche en Informatique et ses Applications (LORIA), Institut National de Recherche en Informatique et en Automatique (Inria)-Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS)-Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Université Henri Poincaré - Nancy 1 (UHP), Centre National de la Recherche Scientifique (CNRS)-Université de Lorraine (UL)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre National de la Recherche Scientifique (CNRS)-Université de Lorraine (UL)-Institut National de Recherche en Informatique et en Automatique (Inria)-Laboratoire Lorrain de Recherche en Informatique et ses Applications (LORIA), Centre National de la Recherche Scientifique (CNRS)-Université de Lorraine (UL)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre National de la Recherche Scientifique (CNRS)-Université de Lorraine (UL)
Jazyk: angličtina
Rok vydání: 2008
Předmět:
Male
medicine.medical_specialty
Visual acuity
genetic structures
Organes des sens
medicine.medical_treatment
Eye disease
Sensory Organs
Sulfur Hexafluoride
Visual Acuity
Médecine humaine et pathologie
Vitrectomy
law.invention
[INFO.INFO-AI]Computer Science [cs]/Artificial Intelligence [cs.AI]
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
law
Ophthalmology
Prone Position
Medicine
Humans
Prospective Studies
Prospective cohort study
Macular hole
ComputingMilieux_MISCELLANEOUS
Aged
Postoperative Care
Fluorocarbons
business.industry
medicine.disease
Retinal Perforations
eye diseases
Surgery
Prone position
Treatment Outcome
030221 ophthalmology & optometry
Female
Human health and pathology
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
Tamponade
medicine.symptom
business
030217 neurology & neurosurgery
Tomography
Optical Coherence
Zdroj: American Journal of Ophthalmology
American Journal of Ophthalmology, Elsevier Masson, 2008, 146 (1), pp.128-134.e1. ⟨10.1016/j.ajo.2008.02.029⟩
American Journal of Ophthalmology 1 (146), 128-134.e1. (2008)
American Journal of Ophthalmology, 2008, 146 (1), pp.128-134.e1. ⟨10.1016/j.ajo.2008.02.029⟩
ISSN: 0002-9394
DOI: 10.1016/j.ajo.2008.02.029⟩
Popis: Purpose To compare two therapeutic modalities on anatomic and functional results after idiopathic macular hole (MH) surgery: seated vs face-down position. Design Multicenter, prospective, randomized trial. Methods setting: University Hospital Dijon and University Hospital Nancy. patients: One hundred and forty-four patients (150 eyes) were enrolled and randomly separated into two groups for postoperative position: for the 72 eyes in the P0 group and the 78 eyes in the P1 group, the patients were asked to keep the seated (P0 group) and the face-down position (P1 group) after the idiopathic MH surgery. intervention: All patients underwent a complete vitrectomy with a fluid-air exchange and an intraocular gas tamponade. After the surgery, patients were asked to keep one of the two randomly chosen positions for five days. main outcome measures: Best-corrected visual acuity (VA), fundus examination, and macular optical coherence tomography were performed before and six months after surgery. Results The overall anatomic success rate was 92.7%. The idiopathic MH sealed in 63 of 72 P0 eyes (87.5%) and 76 of 78 P1 eyes (97.4%) ( P = .027). The mean VA increased 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 post hoc analysis based on the size of the idiopathic MH, the success rate in idiopathic MHs smaller than 400 μm was not influenced by the postoperative position ( P = .47). Conclusions A face-down postoperative position is highly recommended in holes larger than 400 μm. The size of the idiopathic MH seems to be an important factor affecting outcome.
Databáze: OpenAIRE
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