Abstract
Purpose. To report the safety and efficacy of adjustable postoperative position for rhegmatogenous retinal detachment (RRD). Methods. Retrospective review of 536 consecutive RRD eyes that underwent vitrectomy surgery for retina repair from year 2008 to 2014. The retinal breaks were divided into superior, lateral (nasal, temporal, and macular), and inferior locations, according to the clock of breaks. Patients with superior and lateral break location were allowed to have facedown position or lateral decubitus position postoperatively, while patients with inferior break location were allowed to have facedown position. Results. 403 eyes of 400 patients were included. The mean follow-up interval was 22.7 ± 21.3 months. The overall primary retinal reattachment rate was 93.3%. There were 24 (6.0%), 273 (67.7%), and 106 (26.3%) patients with superior, lateral, and inferior break location, respectively. The primary reattachment rate was 95.8%, 92.3%, and 95.3% accordingly. After further divided the break location into subgroups as a function of duration of symptom, postoperative lens situation, number of retinal breaks, and different vitreous tamponade, the primary reattachment rates were all higher than 82%. Conclusion. Adjustable postoperative positioning is effective and safe for RRD repair with different break locations. Choosing postoperative position appropriately according to retinal break locations could be recommended.
Highlights
Pars plana vitrectomy (PPV) with different vitreous tamponade, including both gas and silicone oil, followed by facedown positioning for various durations, is still considered as the most standard and effective treatment procedure for rhegmatogenous retinal detachment (RRD) repair in many regions/countries [1,2,3,4,5,6]
A decade ago, Sharma et al reported a high primary retinal reattachment rate (81.3%) for RRD patients with inferior breaks after PPV with gas tamponade with face up or lateral check down postoperative position for 50 minutes in an hour for 7 days [3]
A complete ocular examination was performed in each patient, including slit lamp examination, visual acuity converted to logarithm of the angle of minimal resolution (LogMAR), intraocular pressure (IOP) measurement, and fundus and peripheral retinal examination
Summary
Pars plana vitrectomy (PPV) with different vitreous tamponade, including both gas and silicone oil, followed by facedown positioning for various durations, is still considered as the most standard and effective treatment procedure for rhegmatogenous retinal detachment (RRD) repair in many regions/countries [1,2,3,4,5,6]. A decade ago, Sharma et al reported a high primary retinal reattachment rate (81.3%) for RRD patients with inferior breaks after PPV with gas tamponade with face up or lateral check down postoperative position for 50 minutes in an hour for 7 days [3]. Martinez-Castillo et al consecutively reported a high primary retinal reattachment rate for pseudophakic RRD patients with inferior breaks after PPV with air/gas tamponade with only 24 hours (93.3%) or even without (90–94%) postoperative facedown position [10,11,12]. Chen et al reported that for RRD repair, the Journal of Ophthalmology primary retinal reattachment rate of PPV with gas tamponade with an adjustable postoperative position (alternative upright or lateral recumbent) was as high as traditional strict facedown position (92.3% versus 89.7%) [13]. This study aims to provide further data on the safety and efficacy of adjustable position for RRD repair
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