We read with interest the inspiring article on the duration of facedown positioning after macular hole surgery and noted that patients were kept under close surveillance to ensure that a strict facedown posture was maintained during the study period (Krohn 2005). The author literally implies round-the-clock (24-hour) facedown posturing.
However, even if the necessary precautions for ophthalmic examination, eyedrop instillation and sleep are taken into account, the practicality of such stringent postoperative management is still doubtful. Daily activities such as having meals, bathing, showering and toileting are essential to good health and wellbeing. Dr Krohn did not describe how patients were able to carry out these activities while maintaining an awkward facedown position at all times.
Properly designed logistics to facilitate the performance of these apparently trivial activities may enhance the study and support the validity of its conclusion.