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Patient adherence to the face-down positioning after macular hole surgery

Authors Shimada Y, Seno Y, Mizuguchi T, Tanikawa A, Horiguchi M

Received 19 February 2017

Accepted for publication 4 April 2017

Published 8 June 2017 Volume 2017:11 Pages 1099—1104

DOI https://doi.org/10.2147/OPTH.S135144

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Yoshiaki Shimada, Yui Seno, Tadashi Mizuguchi, Atsuhiro Tanikawa, Masayuki Horiguchi

Department of Ophthalmology, Fujita Health University Hospital, Aichi, Japan

Purpose: To determine adherence to face-down positioning (FDP) among patients who underwent vitrectomy and gas tamponade for macular hole (MH) repair.
Method: A total of 69 patients (37 females and 32 males) who underwent primary vitrectomy for MH repair were studied. Nurses recorded whether the patient complied with FDP each time they examined the patient. FDP score was obtained from the nursing records; patients were given a score of 1 if they complied with the FDP and 0 if they did not. The score was recorded four times per day for the first 3 postoperative days. A perfect FDP score was 12.
Results: The mean ± standard deviation of the FDP scores was 10.6±1.8 (range: 4–12). Overall, 32 (46.4%) patients scored a perfect 12, and 7 (10.1%) patients scored <8. Failure of the MH closure was observed in only one patient (1.4%), who showed the poorest adherence to FDP (score =4). Consequently, the closure rate in patients with FDP score <7 (2/3, 66.7%) was significantly lower than in patients with an FDP score ≥7 (66/66, 100%) (P<0.05, Fisher’s exact probability test).
Conclusion: While adherence to FDP after MH surgery was better than that observed after vitrectomy for rhegmatogenous retinal detachments in our previous study, the percentage of patients with FDP scores <8 did not differ. Statistically, the poor adherence to FDP can negatively impact the effectiveness of the surgery for MH repair.

Keywords: adherence, face-down positioning, gas tamponade, macular hole, vitrectomy

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