Early foveal recovery after macular hole surgery

Aims: To evaluate morphological and functional recovery after macular hole surgery using pars plana vitrectomy (PPV), inner limiting membrane (ILM) peeling, air-tamponade and short-time limited face-down positioning. Design: Retrospective, interventional, non-comparative consecutive case series. Patients: Thirty eyes in 30 patients (30 eyes) with unilateral full-thickness macular hole (stage II-IV). Intervention: All eyes underwent PPV, ILM peeling and fluid-air exchange followed by postoperative face-down positioning for 2 days. Main outcome measures: Best corrected visual acuity, optical coherence tomography (OCT) assessment of macular integrity, and biomicroscopy at days 3 and 7, and months 1, 3, 6 and 12. Results: On postoperative day 3, OCT demonstrated macular hole closure in 28 eyes (93%). One eye required vitrectomy 7 weeks after initial surgery due to retinal detachment. Conclusions: In the present case series, PPV with Trypan Blue-assisted ILM peeling, short-acting internal tamponade and thus shorter face-down positioning was associated with a 93% macular hole closure rate.