Impact of postoperative positioning on the outcome of pars plana vitrectomy with gas tamponade for primary rhegmatogenous retinal detachment: comparison between supine and prone positioning

Acta Ophthalmol. 2018 Mar;96(2):e189-e194. doi: 10.1111/aos.13482. Epub 2017 May 27.

Abstract

Purpose: To compare the postoperative anatomic success rates and the frequency of complications between prone or supine postoperative positioning after transconjunctival sutureless vitrectomy (TSV) for rhegmatogenous retinal detachment (RRD).

Methods: All patients underwent primary 27-gauge TSV for the treatment of primary RRD. Patients were divided into two groups as follows: group A was patients instructed to keep strict postoperative prone positioning for a minimum of 8 days. Group B was patients instructed to keep the prone positioning on the day of the surgery followed by supine positioning for minimum of 7 days from the day after surgery.

Result: Sixty-two eyes were enrolled (group A: 32, group B: 30). There was no significant difference in baseline data between two groups. The initial and final anatomical success rates were 93.8% and 100% in group A and 93.3% and 100% in group B, respectively (p = 1, p = 1, respectively). Posterior synechia of the iris occurred in one eye in group A and in two eyes in group B (p = 0.61). Macular pucker and retinal fold did not occur in either group. Preoperative intraocular pressure (IOP; mmHg) was 14.5 ± 2.9 in group A and 14.5 ± 2.6 in group B (p = 0.92). Intraocular pressure (IOP) was not statistically different between the groups during the follow-up period (p = 0.36, p = 0.07, respectively).

Conclusion: Supine positioning may be an option as a postoperative positioning after TSV and gas tamponade for the treatment of RRD.

Keywords: postoperative positioning; prone positioning; retinal detachment; supine positioning.

Publication types

  • Comparative Study

MeSH terms

  • Endotamponade*
  • Female
  • Humans
  • Laser Coagulation
  • Lens Implantation, Intraocular
  • Male
  • Middle Aged
  • Patient Positioning
  • Phacoemulsification
  • Postoperative Period
  • Prone Position*
  • Retinal Detachment / surgery*
  • Retrospective Studies
  • Sulfur Hexafluoride / administration & dosage*
  • Supine Position*
  • Treatment Outcome
  • Visual Acuity / physiology
  • Vitrectomy*

Substances

  • Sulfur Hexafluoride