Impact of Face-Down and Book-Reading Positions on the Success of Macular Hole Surgery.

Objective: To evaluate the impact of face-down positioning (FDP) and book reading position (BRP) on the success of full-thickness macular hole (FTMH) surgery and their influence on patients' quality of life.

Study design: Descriptive, analytical study. Place and Duration of the Study: Department of Ophthalmology, Medicana International Izmir Hospital, Izmir, Turkiye, from January 2018 to June 2024.

Methodology: Thirty-six patients adopted the FDP after surgery (Group 1), and another 36 adopted the BRP (Group 2) following FTMH surgery. The two groups were compared in terms of preoperative patient data, postoperative parameters, success rates, and complications. Additionally, patients filled the short form-36 (SF-36) quality of life questionnaire preoperatively and at the first 1-month postoperative check-up. Continuous variables were compared using the independent Student's t-test or the Mann-Whitney U test, as appropriate. Categorical variables were analysed using the Chi-square test.

Results: Functional success was achieved in 26 (72.2%) patients in Group 1 and 29 (80.6%) patients in Group 2 (p = 0.405). Anatomical success was obtained in 34 (94.4%) patients in both Group 1 and Group 2 (p >0.99). Complications occurred in 5 (13.8%) patients in Group 1, and 4 (11.1%) in Group 2 (p = 0.443). Three subdomains of SF-36, including physical functioning, bodily pain, and general health, significantly improved in Group 2 compared with Group 1 (p <0.05 for all three parameters).

Conclusion: The results of this study indicated that FDP and BRP had similar effects on the anatomical and functional success and complications of FTMH surgery. However, patients in the BRP group had significantly better quality of life following surgery, according to the SF-36 questionnaire.

Key words: Book reading position, Face-down positioning, Macular hole surgery, Short form-36.