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Jpn J Ophthalmol. 2009 May;53(3):215-8. doi: 10.1007/s10384-008-0642-7. Epub 2009 May 31.

Idiopathic macular hole vitrectomy without postoperative face-down positioning.

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  • 1Second Department of Ophthalmology, Toho University School of Medicine, Faculty of Medicine, Tokyo, Japan.



To evaluate the efficacy of vitrectomy with internal limiting membrane (ILM) peeling and SF(6) gas tamponade for macular holes without face-down positioning.


Twenty-one eyes of 21 consecutive patients undergoing pars plana vitrectomy with indocyanine green-assisted ILM peeling and 20% SF(6) gas tamponade without face-down positioning were included in this study. Biomicroscopy and optical coherence tomography were used to assess macular hole closure. Pre- and postoperative visual acuities (VAs) were compared.


Among the 21 eyes, five (23.8%) had stage 2, 11 (52.4%) stage 3, and five (23.8%) stage 4 macular holes. Mean macular hole size was 0.35 disc diameters. The macular holes had been present for an average of 2.3 months. Twenty eyes (95.2%) were phakic, and one (4.8%) was pseudophakic. Nineteen of the 21 holes (90.5%) initially closed. The final closure rate was 100%, and no eyes showed reopening. Preoperative mean VA (logMAR) was 0.65, and mean VA had significantly improved to 0.46 at 1 month and to 0.42 at 3 months after surgery (P < 0.0001, repeated measures analysis of variance).


Vitrectomy with ILM peeling and SF(6) gas tamponade for macular holes without face-down positioning achieved favorable anatomical and functional results.

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