Background: After pars plana vitrectomy with internal limiting membrane (ILM) peeling and gas tamponade, patients are often required to remain in a face-down position (FDP) to allow the gas bubble to push against the macular hole (MH) to promote hole closure. However, this position may be uncomfortable and inconvenient for the elderly and those with medical comorbidities; it may also lead to certain postoperative complications. Hence, this study aimed to evaluate and compare the effect of postoperative FDP and non-face-down position (nFDP) on the closure rate of MHs following MH surgery.
Methods: Randomized controlled trials (RCTs) were selected through an electronic search of the Cochrane Library, Pubmed, and Embase databases. Trial eligibility and risk of bias were assessed according to Cochrane review methods. The primary measures included overall MH closure rate and subgroup analysis based on MH size. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated. Statistical analysis was performed using RevMan 5.0 software and Stata software 15.0.
Results: Five RCTs composed of a total of 183 eyes in the FDP group and 175 eyes in the nFDP group were included in this meta-analysis. Statistical meta-analysis revealed that the overall MH closure rate in the FDP group was significantly higher than that in the nFDP group (OR = 2.27, 95% CI: 1.02 to 5.05, P = 0.04). For MH sizes smaller than 400 μm, the subgroup meta-analysis indicated that the closure rate of the FDP group was not significantly higher than that of the nFDP group (OR = 1.32, 95% CI: 0.39 to 4.49, P = 0.66). However, when MH size was larger than 400 μm, there was a significantly higher closure rate in the FDP group (OR = 2.95, 95% CI: 1.10 to 7.94, P = 0.03).
Conclusions: Our results provide evidence that a face-down postoperative position seems to be unnecessary when MHs are smaller than 400 μm but may be highly recommended for MHs larger than 400 μm. Further RCTs with large sample sizes are warranted to validate these findings in future.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6925505 | PMC |
| http://dx.doi.org/10.1186/s12886-019-1272-1 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Detailed analysis of cystic lesions in patients after open fetal repair and postnatal myelomeningocele closure.
Childs Nerv Syst
January 2025
Division of Neurosurgery, Department of Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Purpose: We sought to evaluate the incidence, natural history, and management of cystic spinal lesions following myelomeningocele/myeloschisis closure.
Methods: We performed a single-center retrospective review of all patients who underwent myelomeningocele/myeloschisis closure from 2013 to 2018 with follow-up to 5 years old.
Results: We analyzed 100 fetal repairs and 81 postnatal closures from 305 total surgeries.
Construction of Loop Polyzwitterion Brushes on PET Sheets via the Chain-End Closure Strategy To Improve Antifouling and Hemocompatible Properties.
Langmuir
January 2025
Jiangsu Collaborative Innovation Center of Biomedical Functional Materials, Jiangsu Key Laboratory of Bio-functional Materials, Department of Materials Science and Engineering, School of Chemistry and Materials Science, Nanjing Normal University, Nanjing 210023, P. R. China.
Steric stabilization and lubrication give loop polymer brushes enhanced antifouling properties. In the study, linear zwitterionic poly(NMASMCMS) brushes were first constructed on a poly(ethylene terephthalate) (PET) surface through surface-initiated reversible addition-fragmentation chain-transfer (SI-RAFT) polymerization. The tethered linear brushes on sheets were then thiolated with ethanolamine, followed by oxidation to form loop brushes.
View Article and Find Full Text PDFInterrogation of Enantioselectivity in the Photomediated Ring Contractions of Saturated Heterocycles.
J Am Chem Soc
January 2025
Department of Chemistry, University of California, Berkeley, Berkeley, California 94720, United States.
We recently reported a chiral phosphoric acid (CPA) catalyzed enantioselective photomediated ring contraction of piperidines and other saturated heterocycles. By extruding a single heteroatom from a ring, this transformation builds desirable C(sp)-C(sp) bonds in the ring contracted products; however, the origins of enantioselectivity remain poorly understood. In this work, enantioselectivity of the ring contraction has been explored across an expanded structurally diverse substrate scope, revealing a wide range of enantioselectivities (0-99%) using two distinct CPA catalysts.
View Article and Find Full Text PDFRational Fabrication of Functionally-Graded Surfaces for Biological and Biomedical Applications.
Acc Mater Res
December 2024
The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia 30332, United States.
As a ubiquitous feature of the biological world, gradation, in either composition or structure, is essential to many functions and processes. Taking protein gradation as an example, it plays a pivotal role in the development and evolution of human bodies, including stimulation and direction of the outgrowth of peripheral nerves in a developing fetus. It is also critically involved in wound healing by attracting and guiding immune cells to the site of injury or infection.
View Article and Find Full Text PDFEnteral Feeding in Patients With Open Abdomen and Negative Pressure Therapy: A Propensity Score Analysis.
J Abdom Wall Surg
December 2024
Anesthesiology and Critical Care Department, Pellegrin University Hospital, Bordeaux, France.
Introduction: In critically ill surgical patients treated with open abdomen and negative pressure therapy (OA/NPT), the association between nutritional support and clinical outcome is still controversial. The main objective of this study was to assess the effect of enteral nutritional support during the acute phase (i.e.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!