OCT-based positioning regimen for macular hole surgery varies with risk factors

A modified OCT-based positioning regimen based on risk factors may be used to obtain complete, persistent closure of macular holes or to determine the duration of postoperative positioning, according to a study.If a patient has no high-risk factors for failure, defined as high myopia, chronic holes for more than 1 year or large holes greater than 400 µm, the surgeon may choose to stop positioning once the hole is confirmed on OCT imaging to be closed. In cases with one risk factor, the surgeon may want to consider extending the positioning for a few days after the hole is closed. In the presence of two or three risk factors, the study authors suggested a full 7 days of prone positioning even if the hole is closed on postoperative day 1.