Comparison of face-down posturing with nonsupine posturing after macular hole surgery: a meta-analysis
Abstract Background A few randomized controlled trials (RCTs) have evaluated face-down posturing (FDP) with the far less physically challenging nonsupine posturing (NSP) in the treatment of idiopathic full-thickness macular holes (MHs). The objective of our study was to evaluate the efficacy of post...
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| Format: | Article |
| Language: | English |
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BMC
2019-01-01
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| Series: | BMC Ophthalmology |
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| Online Access: | http://link.springer.com/article/10.1186/s12886-019-1047-8 |
| _version_ | 1819153112708939776 |
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| author | Song Xia Xin-yu Zhao Er-qian Wang You-xin Chen |
| author_facet | Song Xia Xin-yu Zhao Er-qian Wang You-xin Chen |
| author_sort | Song Xia |
| collection | DOAJ |
| description | Abstract Background A few randomized controlled trials (RCTs) have evaluated face-down posturing (FDP) with the far less physically challenging nonsupine posturing (NSP) in the treatment of idiopathic full-thickness macular holes (MHs). The objective of our study was to evaluate the efficacy of postoperative posturing on the anatomical and functional outcomes of MH surgery. Methods The PubMed, Embase, and Cochrane Central Register of Controlled Trials databases were searched from their earliest entries through December 2016 to identify the studies that had evaluated the effects of postoperative posturing with FDP or NSP for patients with MH surgery. The PRISMA guidelines were followed. The relevant data were analyzed using StataSE 12.0 software. The weighted mean difference (WMD), relative risk (RR) and their 95% confidence intervals (95% CIs) were used to assess the strength of the association. Results Our search yielded 181 records from which 11 studies comprising 726 cases that had examined the effects of postoperative posturing with FDP for patients compared with NSP after MH surgery were included for review and analysis. Our meta-analyses showed that postoperative FDP could generally improve the overall MH closure rate compared to NSP (OR = 1.828, 95% CI: 1.063~3.143, P = 0.029). Subgroup analysis of the size of MH suggested a significant benefit of FDP for large MHs (≥400 μm) (OR = 4.361, 95% CI: 1.429~13.305, P = 0.010) while there was no difference in the MH closure rate for small MHs (< 400 μm) (OR = 1.731, 95% CI: 0.412~7.270, P = 0.453). Moreover, ILM peeling for large MHs could significantly increase the MH closure rate of the FDP group (OR = 2.489, 95% CI: 1.021~6.069, P = 0.045), while no difference existed for small MHs (OR = 3.572, 95% CI: 0.547~23.331, P = 0.184). Combined cataract surgery might not influence the MH closure rate under any circumstance (OR = 0.513, 95% CI: 0.089~2.944, P = 0.454). Conclusion Based on all the available evidence, our study found that FDP after MH surgery could generally improve the overall MH closure rate compared to NSP. For MHs larger than 400 μm, ILM peeling combined with FDP could significantly increase the MH closure rate. Combined cataract surgery might not influence the MH closure rate. |
| first_indexed | 2024-12-22T15:00:01Z |
| format | Article |
| id | doaj.art-4fa630fe90494f35b2b615bf331f4c8c |
| institution | Directory Open Access Journal |
| issn | 1471-2415 |
| language | English |
| last_indexed | 2024-12-22T15:00:01Z |
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| spelling | doaj.art-4fa630fe90494f35b2b615bf331f4c8c2022-12-21T18:22:08ZengBMCBMC Ophthalmology1471-24152019-01-0119111010.1186/s12886-019-1047-8Comparison of face-down posturing with nonsupine posturing after macular hole surgery: a meta-analysisSong Xia0Xin-yu Zhao1Er-qian Wang2You-xin Chen3Department of Ophthalmology, Guizhou Provincial People’s HospitalDepartment of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesDepartment of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesDepartment of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesAbstract Background A few randomized controlled trials (RCTs) have evaluated face-down posturing (FDP) with the far less physically challenging nonsupine posturing (NSP) in the treatment of idiopathic full-thickness macular holes (MHs). The objective of our study was to evaluate the efficacy of postoperative posturing on the anatomical and functional outcomes of MH surgery. Methods The PubMed, Embase, and Cochrane Central Register of Controlled Trials databases were searched from their earliest entries through December 2016 to identify the studies that had evaluated the effects of postoperative posturing with FDP or NSP for patients with MH surgery. The PRISMA guidelines were followed. The relevant data were analyzed using StataSE 12.0 software. The weighted mean difference (WMD), relative risk (RR) and their 95% confidence intervals (95% CIs) were used to assess the strength of the association. Results Our search yielded 181 records from which 11 studies comprising 726 cases that had examined the effects of postoperative posturing with FDP for patients compared with NSP after MH surgery were included for review and analysis. Our meta-analyses showed that postoperative FDP could generally improve the overall MH closure rate compared to NSP (OR = 1.828, 95% CI: 1.063~3.143, P = 0.029). Subgroup analysis of the size of MH suggested a significant benefit of FDP for large MHs (≥400 μm) (OR = 4.361, 95% CI: 1.429~13.305, P = 0.010) while there was no difference in the MH closure rate for small MHs (< 400 μm) (OR = 1.731, 95% CI: 0.412~7.270, P = 0.453). Moreover, ILM peeling for large MHs could significantly increase the MH closure rate of the FDP group (OR = 2.489, 95% CI: 1.021~6.069, P = 0.045), while no difference existed for small MHs (OR = 3.572, 95% CI: 0.547~23.331, P = 0.184). Combined cataract surgery might not influence the MH closure rate under any circumstance (OR = 0.513, 95% CI: 0.089~2.944, P = 0.454). Conclusion Based on all the available evidence, our study found that FDP after MH surgery could generally improve the overall MH closure rate compared to NSP. For MHs larger than 400 μm, ILM peeling combined with FDP could significantly increase the MH closure rate. Combined cataract surgery might not influence the MH closure rate.http://link.springer.com/article/10.1186/s12886-019-1047-8Macular holeFace-downPosturingMeta-analysis |
| spellingShingle | Song Xia Xin-yu Zhao Er-qian Wang You-xin Chen Comparison of face-down posturing with nonsupine posturing after macular hole surgery: a meta-analysis BMC Ophthalmology Macular hole Face-down Posturing Meta-analysis |
| title | Comparison of face-down posturing with nonsupine posturing after macular hole surgery: a meta-analysis |
| title_full | Comparison of face-down posturing with nonsupine posturing after macular hole surgery: a meta-analysis |
| title_fullStr | Comparison of face-down posturing with nonsupine posturing after macular hole surgery: a meta-analysis |
| title_full_unstemmed | Comparison of face-down posturing with nonsupine posturing after macular hole surgery: a meta-analysis |
| title_short | Comparison of face-down posturing with nonsupine posturing after macular hole surgery: a meta-analysis |
| title_sort | comparison of face down posturing with nonsupine posturing after macular hole surgery a meta analysis |
| topic | Macular hole Face-down Posturing Meta-analysis |
| url | http://link.springer.com/article/10.1186/s12886-019-1047-8 |
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