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Face‐down or no face‐down posturing following macular hole surgery: a meta‐analysis
Author(s) -
Hu Zizhong,
Xie Ping,
Ding Yuzhi,
Zheng Xinhua,
Yuan Dongqing,
Liu Qinghuai
Publication year - 2016
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.12844
Subject(s) - meta analysis , medicine , odds ratio , macular hole , confidence interval , randomized controlled trial , subgroup analysis , visual acuity , ophthalmology , surgery , vitrectomy
Purpose To evaluate the impact of postoperative posturing with or without face‐down on the anatomical and functional outcomes of macular hole surgery. Methods A literature‐based meta‐analysis was conducted to identify studies relevant to posturing following macular hole surgery ( MHS ). PubMed and Web of Science databases were used to retrieve articles up to 1 June 2015. The primary measures included MH closure and ideal vision acuity improvement. Pooled odds ratios ( OR s) and 95% confidence intervals ( CI s) were estimated in Review Manager. Results Four randomized control trials ( RCT s) comprising 251 cases were included in the final meta‐analysis. No face‐down posturing ( FDP ) after MHS revealed lower anatomic success rate compared to face‐down posturing ( OR = 0.33, 95% CI [0.13, 0.81], p = 0.02). For holes smaller than 400 μ m in size, the subgroup meta‐analysis indicated no significant effect of FDP on successful hole closure ( OR = 0.29, 95% CI [0.01, 7.34], p = 0.45). However, when holes were larger than 400 μ m, it seemed less effective on MH closure following surgery in no FDP group ( OR = 0.23, 95% CI [0.07, 0.71]), and this was statistically significant (p = 0.01). Conclusions Our work found that no FDP was not inferior to its face‐down counterpart for the success of MHS when macular holes were smaller than 400 μ m in size. For macular holes larger than 400 μ m, statistical analysis proved that FDP might be necessary. More well‐conducted randomized control trials are needed to verify our findings.