Computational fluid dynamics (CFD) simulation analysis on retinal gas cover rates using computational eye models

Makoto Gozawa,Yoshihiro Takamura,Masaru Inatani,Kentaro Iwasaki,Tomoe Aoki

doi:10.1038/s41598-021-84574-2

Makoto Gozawa, Yoshihiro Takamura + Show 3 more

Open Access

https://doi.org/10.1038/s41598-021-84574-2

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Journal: Scientific Reports	Publication Date: Mar 2, 2021
Citations: 3	License type: open-access

Affiliation: University of Fukui

Abstract

We investigated the change in the retinal gas cover rates due to intraocular gas volume and positions using computational eye models and demonstrated the appropriate position after pars plana vitrectomy (PPV) with gas tamponade for rhegmatogenous retinal detachments (RRDs). Computational fluid dynamic (CFD) software was used to calculate the retinal wall wettability of a computational pseudophakic eye models using fluid analysis. The model utilized different gas volumes from 10 to 90%, in increments of 10% to the vitreous cavity in the supine, sitting, lateral, prone with closed eyes, and prone positions. Then, the gas cover rates of the retina were measured in each quadrant. When breaks are limited to the inferior retina anterior to the equator or multiple breaks are observed in two or more quadrants anterior to the equator, supine position maintained 100% gas cover rates in all breaks for the longest duration compared with other positions. When breaks are limited to either superior, nasal, or temporal retina, sitting, lower temporal, and lower nasal position were maintained at 100% gas cover rates for the longest duration, respectively. Our results may contribute to better surgical outcomes of RRDs and a reduction in the duration of the postoperative prone position.

Highlights

We investigated the change in the retinal gas cover rates due to intraocular gas volume and positions using computational eye models and demonstrated the appropriate position after pars plana vitrectomy (PPV) with gas tamponade for rhegmatogenous retinal detachments (RRDs)
The gas cover rate was 100% until the gas volume was reduced to 70% in all models
In the prone with closed eyes position, the gas cover rate was maintained at 100% until the gas volume was reduced to 80% in all models

Summary

Introduction

We investigated the change in the retinal gas cover rates due to intraocular gas volume and positions using computational eye models and demonstrated the appropriate position after pars plana vitrectomy (PPV) with gas tamponade for rhegmatogenous retinal detachments (RRDs). When breaks are limited to either superior, nasal, or temporal retina, sitting, lower temporal, and lower nasal position were maintained at 100% gas cover rates for the longest duration, respectively. A proper postoperative position should be maintained after PPV with gas tamponade so that the gas can adequately cover the retinal breaks until the retina is well attached. Martinez-Castillo et al reported that PPV alone, with no prone position in the postoperative period, achieves a high reattachment rate without severe postoperative complications in the management of pseudophakic RRDs due to inferior retinal breaks[15]. Intraocular gas decreases with time after surgery, and the intraocular gas makes the contact angle to the retina that affects retinal gas coverage[5]

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