Objective To evaluate the surgical outcomes of 25G⁺ vitrectomy with air tamponade and 1-day prone positioning for idiopathic macular hole (IMH).Methods A prospective analysis was performed on 39 patients (39 eyes) underwent 25G⁺ pars plana vitrectomy (PPV) combined with the internal limiting membrane (ILM) removal and fluid-air exchange for IMH from July 2012 to December 2013. After vitrectomy, patients were instructed to keep prone positioning for only 1 day (the air group). These patients were compared to 30 consecutive patients from July 2010 to July 2012, who were conducted 25G⁺ PPV with 25% SF₆ tamponade. They remained in the same face-down position for 3 days postoperatively (SF₆ group). Age, gender, logMAR BCVA, macular thickness, macular hole diameter, axial length, macular hole stages and pseudophakic status were collected as baseline characteristics in both groups. The initial hole-closure rate, visual outcome and intra-operative & post-operative complications were evaluated for 6 months. Group comparisons of numeric variables were made by using two sample t -test. Group difference of categorical variables was determined by using standard chi-square test or rank sum test.Results Thirty nine patients (39 eyes) and 30 patients (30 eyes) were respectively enrolled in air group and SF₆ group. The distribution of age (t=－1.63), gender (χ²=0.03), logMAR BCVA (t=0.39), macular thickness (t=－0.93), macular hole diameter (t=－0.70), axial length (t=－0.56), macular hole stages (Z=－0.47) and pseudophakic status (χ²=0.13) was similar in both groups. Anatomical closure of macular holes was achieved in 35 (89.7%) of the 39 eyes in the air group and in 27 eyes (90.0%) in the SF₆ group. There was no significant difference of closure rate between the two groups (χ²=0.001, P=0.970). The postoperative visual acuity of gaining, stability and decreasing 2 or more 2 lines was achieved in 23 eyes,10 eyes and 6 eyes in air group and 18 eyes, 6 eyes and 6 eyes in SF₆ group. The proportion of visual acuity improvement in air group was lower than that in SF₆ group without the statistical significance (Z=－0.08, P=0.93). The gas bubble was absorbed sooner in the air group (mean 8.54±1.74 days) than in the SF₆ group (mean 31.10±3.20 days). No retinal break, retinal detachment or endophthalmitis occurred in either group. Postoperatively intraocular pressure was elevated temporarily in 2 eyes of the air group and 3 eyes in the SF₆ group. All returned to normal limit after local medication.Conclusion Compared to SF₆ group, air group has similar anatomical macular hole closure rate and visual acuity rehabilitation.

Citation： Liu Juping, Huang Liangyu, Ren Xinjun, Li Xiaorong. Clinical outcomes of vitrectomy with air tamponade and 1-day prone positioning in the treatment of idiopathic macular hole. Chinese Journal of Ocular Fundus Diseases, 2020, 36(7): 499-503. doi: 10.3760/cma.j.cn511434-20190508-00172 Copy