Face-Down Posture versus Non-Face-Down Posture following Large Idiopathic Macular Hole Surgery: A Systemic Review and Meta-Analysis

Evidence regarding the effect of a face-down posture (FDP) for large idiopathic macular hole (IMH) is inconsistent. We conducted a systematic review and meta-analysis to determine whether a postoperative FDP is required for the treatment of large IMH. Eligible randomized controlled trials published...

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Autores principales:	Hou-Ren Tsai, Tai-Li Chen, Chun-Yu Chang, Huei-Kai Huang, Yuan-Chieh Lee
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	face-down posture idiopathic macular holes systemic review Medicine R
Acceso en línea:	https://doaj.org/article/9b792c6f9c484f578192d5475a228182
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spelling	oai:doaj.org-article:9b792c6f9c484f578192d5475a2281822021-11-11T17:32:46ZFace-Down Posture versus Non-Face-Down Posture following Large Idiopathic Macular Hole Surgery: A Systemic Review and Meta-Analysis10.3390/jcm102148952077-0383https://doaj.org/article/9b792c6f9c484f578192d5475a2281822021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/4895https://doaj.org/toc/2077-0383Evidence regarding the effect of a face-down posture (FDP) for large idiopathic macular hole (IMH) is inconsistent. We conducted a systematic review and meta-analysis to determine whether a postoperative FDP is required for the treatment of large IMH. Eligible randomized controlled trials published before September 2021 were retrieved from the Medline, Embase, and Cochrane Library databases. The efficacy outcome was the IMH closure rate and the visual acuity improvement rate. A meta-analysis was performed using a random effects model. The “Grading of Recommendations Assessment, Development, and Evaluation” approach was implemented, and the numbers needed-to-treat (NNTs) were calculated. Seven studies comprising 640 patients were included. We performed a predefined subgroup analysis of IMH size using a cut-off point of 400 µm. Compared with non-FDP, a significant effect of FDP was found in the IMH > 400 µm group (OR = 3.34; 95% CI = 1.57–7.14; trial sequential analysis-adjusted CI = 1.20–11.58; NNTs = 7.9). After stratifying by the posturing periods, the beneficial effect of FDP lasting at least five days, but not three days was observed for large IMH. Maintaining a FDP for at least five days postoperatively is an effective strategy (certainty of evidence: “moderate”) for treating large IMH.Hou-Ren TsaiTai-Li ChenChun-Yu ChangHuei-Kai HuangYuan-Chieh LeeMDPI AGarticleface-down postureidiopathic macular holessystemic reviewMedicineRENJournal of Clinical Medicine, Vol 10, Iss 4895, p 4895 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	face-down posture idiopathic macular holes systemic review Medicine R
spellingShingle	face-down posture idiopathic macular holes systemic review Medicine R Hou-Ren Tsai Tai-Li Chen Chun-Yu Chang Huei-Kai Huang Yuan-Chieh Lee Face-Down Posture versus Non-Face-Down Posture following Large Idiopathic Macular Hole Surgery: A Systemic Review and Meta-Analysis
description	Evidence regarding the effect of a face-down posture (FDP) for large idiopathic macular hole (IMH) is inconsistent. We conducted a systematic review and meta-analysis to determine whether a postoperative FDP is required for the treatment of large IMH. Eligible randomized controlled trials published before September 2021 were retrieved from the Medline, Embase, and Cochrane Library databases. The efficacy outcome was the IMH closure rate and the visual acuity improvement rate. A meta-analysis was performed using a random effects model. The “Grading of Recommendations Assessment, Development, and Evaluation” approach was implemented, and the numbers needed-to-treat (NNTs) were calculated. Seven studies comprising 640 patients were included. We performed a predefined subgroup analysis of IMH size using a cut-off point of 400 µm. Compared with non-FDP, a significant effect of FDP was found in the IMH > 400 µm group (OR = 3.34; 95% CI = 1.57–7.14; trial sequential analysis-adjusted CI = 1.20–11.58; NNTs = 7.9). After stratifying by the posturing periods, the beneficial effect of FDP lasting at least five days, but not three days was observed for large IMH. Maintaining a FDP for at least five days postoperatively is an effective strategy (certainty of evidence: “moderate”) for treating large IMH.
format	article
author	Hou-Ren Tsai Tai-Li Chen Chun-Yu Chang Huei-Kai Huang Yuan-Chieh Lee
author_facet	Hou-Ren Tsai Tai-Li Chen Chun-Yu Chang Huei-Kai Huang Yuan-Chieh Lee
author_sort	Hou-Ren Tsai
title	Face-Down Posture versus Non-Face-Down Posture following Large Idiopathic Macular Hole Surgery: A Systemic Review and Meta-Analysis
title_short	Face-Down Posture versus Non-Face-Down Posture following Large Idiopathic Macular Hole Surgery: A Systemic Review and Meta-Analysis
title_full	Face-Down Posture versus Non-Face-Down Posture following Large Idiopathic Macular Hole Surgery: A Systemic Review and Meta-Analysis
title_fullStr	Face-Down Posture versus Non-Face-Down Posture following Large Idiopathic Macular Hole Surgery: A Systemic Review and Meta-Analysis
title_full_unstemmed	Face-Down Posture versus Non-Face-Down Posture following Large Idiopathic Macular Hole Surgery: A Systemic Review and Meta-Analysis
title_sort	face-down posture versus non-face-down posture following large idiopathic macular hole surgery: a systemic review and meta-analysis
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/9b792c6f9c484f578192d5475a228182
work_keys_str_mv	AT hourentsai facedownpostureversusnonfacedownposturefollowinglargeidiopathicmacularholesurgeryasystemicreviewandmetaanalysis AT tailichen facedownpostureversusnonfacedownposturefollowinglargeidiopathicmacularholesurgeryasystemicreviewandmetaanalysis AT chunyuchang facedownpostureversusnonfacedownposturefollowinglargeidiopathicmacularholesurgeryasystemicreviewandmetaanalysis AT hueikaihuang facedownpostureversusnonfacedownposturefollowinglargeidiopathicmacularholesurgeryasystemicreviewandmetaanalysis AT yuanchiehlee facedownpostureversusnonfacedownposturefollowinglargeidiopathicmacularholesurgeryasystemicreviewandmetaanalysis
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Face-Down Posture versus Non-Face-Down Posture following Large Idiopathic Macular Hole Surgery: A Systemic Review and Meta-Analysis

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