Dear Rob

We are just about to start an RfPB funded study which we hope will address this uncertainly once and for all.  The main issue is that absence of evidence is never evidence of absence (have a look at the BJO ophthalmic statistics note 2) and so large studies are needed to reduce uncertainty.  Some patients have indicated that they would be happy to posture if it lowered the chance of their needing repeat surgery even slightly.

best wishes

Catey

Hi Catey

Well done getting funding for that, it will be a useful study. I personally have not postured anyone for some years, but I think that is because I peel ILM and use platelets to encourage early hole closure.

Regards

Rob

I have been looking at the audit from Richard Newsome and there is not justification for posturing after macular hole surgery

Are you referring to the 2007 publication or is there something more recent than this. Typically an audit would not be viewed as the same level of evidence as an RCT because of the potential for biases.

I am referring to his recent ARVO presentation. I agree with you to a large degree, but macular holes are a fairly homogenous group and he has not noticed a drop in his success rate by not posturing, which is 93% for all comers. Your trial will of course be the icing on the cake.

Thanks Rob.  I didnt attend ARVO this year but will see if I can find the abstract.