Abstract: The majority of macular hole surgery, vitrectomy combined with internal limiting membrane peeling and vitreous cavity gas filling, require special postoperative positions, such as face-down position (FDP). The study of postoperative position selection and monitoring can help improve patient compliance, increase the time in the correct position and reduce the time in a poor position. How to reduce the FDP time or develope other positions and procedures that can replace FDP while ensuring the macular hole closure rate is the focus of the study. Strict maintenance of FDP for a certain period is the standard postoperative care procedure for patients with macular hole >400 μm. The effect of postoperative non-supine position compared with FDP on the rate of hole closure when the macular hole is < 400 μm has not been concluded. Current FDP position monitors include Maculog electronic device, curved fixture head position monitor connected to headphones, head fixed sensor, and adhesive eye mask with the sensor. For non-supine position monitoring, there are roll ball type sensors with tilt switch type head position monitoring devices, and wearable wireless positioning sensor with real-time audio-visual feedback, which can serve as a reminder and record of patient's postoperative position. Some studies have used intraoperative and postoperative OCT examinations to guide the duration of FDP. (Int Rev Ophthalmol, 2023, 47: 283-288)

Key words: macular hole, positioning selection, positioning monitoring