Abstract
PurposeTo compare the anatomic and functional outcomes of pars plana vitrectomy (PPV) for treating rhegmatogenous retinal detachments (RRDs) between two groups with and without postoperative prone positioning.MethodsThis retrospective cohort study included 142 eyes of 142 patients with a primary RRD. All patients underwent PPV with 20% sulfur hexafluoride gas tamponade and were divided into two groups: the groups that did and did not maintain a prone position postoperatively. All patients were followed for more than 3 months. The main outcome measures were the best-corrected visual acuity (BCVA), retinal reattachment rate, and postoperative complications.ResultsSixty-five eyes were included in the prone position group and 77 eyes in the group without prone positioning; the respective initial reattachment rates were 83.1% and 96.1%, a difference that reach significance (p = 0.011). In the eyes with inferior breaks, the initial reattachment rate was 94.7% (18 eyes) without prone positioning, which was significantly (p = 0.036) better than the 60% (6 eyes) initial reattachment rate in the group with prone positioning. In the eyes without inferior breaks, there was no significant difference in the initial reattachment rates between the two groups. The BCVAs at the 3-month postoperative visit did not differ significantly between the two groups. An epiretinal membrane (ERM) was observed postoperatively in 10 (13.0%) eyes in the group without prone positioning; no ERMs were seen postoperatively in eyes in which the internal limiting membrane (ILM) was peeled during PPV.ConclusionsPPV without postoperative prone positioning is associated with a higher reattachment rate in eyes with a RRD, especially those with inferior retinal breaks. PPV with postoperative supine and lateral positioning might be beneficial to manage RRDs associated with inferior retinal breaks if ILM peeling is performed intraoperatively.
Highlights
Pars plana vitrectomy (PPV) with gas tamponade is the surgery performed most frequently to treat rhegmatogenous retinal detachments (RRDs) in developed countries
Sixty-five eyes were included in the prone position group and 77 eyes in the group without prone positioning; the respective initial reattachment rates were 83.1% and 96.1%, a difference that reach significance (p = 0.011)
In the eyes without inferior breaks, there was no significant difference in the initial reattachment rates between the two groups
Summary
Pars plana vitrectomy (PPV) with gas tamponade is the surgery performed most frequently to treat rhegmatogenous retinal detachments (RRDs) in developed countries. Gas tamponade still involves uncomfortable prone positioning postoperatively. PPV and gas tamponade without face-down positioning have been performed to treat macular holes (MHs) [1,2]; few studies have reported the outcomes after PPV to treat RRDs without postoperative prone positioning. Martınez-Castillo et al reported the results of a consecutive non-comparative study of pseudophakic eyes [3] and Chen et al performed a comparative study of PPV using long-acting gas [4]. We retrospectively compared the results achieved with prone positioning with the results without prone positioning after primary PPV to treat RRDs in a larger case series
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