Postoperative Prone Positioning Research Articles

Outcomes of Primary Vitrectomy for Rhegmatogenous Retinal Detachment With No Postoperative Positioning.

Purpose: To evaluate the anatomic and visual outcomes of primary vitrectomy for rhegmatogenous retinal detachment (RRD) repair using no amount of postoperative prone positioning to clarify the role of face-down posturing for RRD reattachment. Methods: This retrospective consecutive interventional case series comprised patients who had primary vitrectomy for RRD repair. The surgical outcomes, single-surgery anatomic success rate, and postoperative best-corrected visual acuity (BCVA) were assessed. The primary objective was to evaluate the anatomic and visual outcomes of vitrectomy RRD reattachment using no postoperative prone positioning. Results: This study comprised 116 eyes of 116 patients. Single-surgery anatomic success was achieved in 112 (96.5%) of 116 eyes. The single-surgery anatomic success rate was 100% in phakic patients (n = 56) and 93% in pseudophakic patients (n = 60), with both groups having an improvement in the mean BCVA. Conclusions: Primary vitrectomy with no postoperative prone positioning is a successful surgical intervention for RRD repair. The anatomic closure rate in this study is one of the highest reported in the literature and involved a large number of macula-off RRDs, with minimal complications and a significant improvement in BCVA, primarily using 14% perfluoropropane for gas tamponade.

Postoperative awake prone position in geriatric patients with hip fractures: a protocol for a randomized controlled trial on the efficacy of postoperative prone position in reducing pulmonary complications and improving oxygenation

IntroductionPostoperative pulmonary complications (PPCs) are prevalent in geriatric patients with hip fractures. Low oxygen level is one of the most important risk factors for PPCs. Prone position has been proven efficacy in improving oxygenation and delaying the progress of pulmonary diseases, especially in patients with acute respiratory distress syndrome induced by multiple etiologies. The application of awake prone position (APP) has also attracted widespread attention in recent years. A randomized controlled trial (RCT) will be carried out to measure the effect of postoperative APP in a population of geriatric patients undergoing hip fracture surgery.MethodsThis is an RCT. Patients older than 65 years old admitted through the emergency department and diagnosed with an intertrochanteric or femoral neck fracture will be eligible for enrollment and assigned randomly to the control group with routine postoperative management of orthopedics or APP group with an additional prone position for the first three consecutive postoperative days (PODs). Patients receiving conservative treatment will not be eligible for enrollment. We will record the difference in the patient’s room-air-breathing arterial partial pressure of oxygen (PaO2) values between the 4th POD (POD 4) and emergency visits, the morbidity of PPCs and other postoperative complications, and length of stay. The incidence of PPCs, readmission rates, and mortality rates will be followed up for 90 PODs.DiscussionWe describe the protocol for a single-center RCT that will evaluate the efficacy of postoperative APP treatment in reducing pulmonary complications and improving oxygenation in geriatric patients with hip fractures.Ethics and disseminationThis protocol was approved by the independent ethics committee (IEC) for Clinical Research of Zhongda Hospital, Affiliated to Southeast University, and is registered on the Chinese Clinical Trial Registry. The findings of the trial will be disseminated through peer-reviewed journals.Ethics approval number2021ZDSYLL203-P01Trial registrationChiCTR ChiCTR2100049311. Registered on 29 July 2021.Trial statusRecruiting. Recruitment is expected to be completed in December 2024.

Postoperative follow-up of submacular hemorrhage displacement treated with vitrectomy and subretinal injection of tissue plasminogen activator: ultrawide-field fundus autofluorescence imaging in gas-filled eyes.

To investigate the utility of Optos ultrawide-field fundus autofluorescence (UWF-FAF) imaging for postoperative follow-up of gas-filled eyes after vitrectomy with subretinal tissue-plasminogen activator (t-PA) injection for subretinal hemorrhage (SRH) displacement. Retrospective consecutive case series. This study included 24 eyes with SRH. Vitrectomy with subretinal t-PA injection was performed, followed by postoperative prone positioning. FAF images acquired using Optos California were examined and the SRH occupancy in the macula was calculated. The main outcome measures were displacement rate and direction of SRH for 3days postoperatively, and postoperative best-corrected visual acuity (BCVA). The postoperative BCVA ranged from improvement (23 eyes; 95.8%) to no change (one eye; 4.2%). Analysis was done using postoperative Optos FAF images for 20 eyes (83.3%). Postoperative SRH occupancy was significantly reduced, by 27.4%, compared with the preoperative occupancy (P = 0.03). A statistically significant reduction was found between the preoperative and postoperative day (POD)1 (P = 0.04), but not between POD1 and POD2 (P = 0.7), or between POD2 and POD3 (P = 1.0). UWF-FAF imaging is useful for postoperative follow-up of gas-filled eyes after vitrectomy with subretinal t-PA injection for SRH displacement.

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

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.

Evaluation of intraocular gas using magnetic resonance imaging after pars plana vitrectomy with gas tamponade for rhegmatogenous retinal detachment

We used magnetic resonance imaging (MRI) to assess how a patient’s posture affects intraocular gas changes and whether the postoperative prone position is required after pars plana vitrectomy (PPV) with gas tamponade for rhegmatogenous retinal detachments (RRDs). Eight patients with RRDs who underwent PPV combined with cataract surgery with gas tamponade were prospectively included. They underwent MRI examination both in the prone and supine positions. We separated the retina into four parts: superior–posterior, superior–anterior, inferior–posterior, and inferior–anterior. We then calculated the gas contact rate as (the length of the retina contacting the gas in each retinal part) divided by (the length of each retinal part) × 100% in both the prone and supine positions. The mean gas contact rate of the superior–anterior part of the retina was significantly higher (P = 0.006) in the supine position than in the prone position. The mean gas contact rate of the inferior–anterior part of the retina was also significantly higher (P = 0.0004) in the supine position than in the prone position. We believe that if all retinal breaks were located anterior to the equator, the supine position may provide better tamponade gas coverage for the breaks than the prone position. Although potential postoperative complications caused by the supine position require careful attention, our result may shorten the duration of postoperative prone position and may decrease the patients’ discomfort after PPV with gas tamponade for RRDs.

The Role of Single-Layered Flap in Temporal Inverted Internal Limiting Membrane Flap Technique for Macular Holes: Pros and Cons.

Purpose To assess the safety and effectiveness of the single-layered inverted internal limiting membrane (ILM) flap technique for treating chronic, large, or highly myopic macular holes (MHs). Methods The medical records of 20 eyes of 20 consecutive Japanese patients with large MHs (n=6) (minimal diameter, >400 μm), chronic MHs (n=2) (symptom duration, >24 months), MHs in high myopia (n=11) (axial length, >26 mm), and MHs in a patient unable to maintain prone positioning postoperatively (n=1) were reviewed retrospectively. All patients underwent 25-gauge pars plana vitrectomy and the temporal inverted ILM flap technique. A semicircular ILM notch was made temporally two disc diameters from the MH using a 25-gauge knife, and the ILM was peeled temporally to create a semicircular ILM flap using a 25-gauge forceps. The single-layered ILM flap was inverted in a nasal direction to cover the MH. When an epiretinal membrane (ERM) was present, it was peeled before the ILM flap was inverted. Results The MHs closed successfully in all (100%) eyes postoperatively. In the MHs associated with an ERM, after hole closure, gradual foveal deformation occurred in both the area from which the ILM was not peeled and the ILM flap inverted side. Conclusions The single-layered inverted ILM flap technique, a simple surgery to treat MHs, provides scaffolding for retinal gliosis and may facilitate bridge formation between the walls of the MH under the flap. Considering the 100% success rate of MH closure, this technique seems to be effective and safe for treating chronic, large, or highly myopic MHs and MHs in patients unable to maintain postoperative prone positioning. In the MHs associated with ERMs, gradual foveal deformation was observed after ERM peeling. Further studies are needed to minimize surgical complications and understand the mechanism of this technique. This trial is registered with UMIN000035091.

Vitrectomy without prone positioning for rhegmatogenous retinal detachments in eyes with inferior retinal breaks.

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.

Qualitative research on post-vitrectomy prone position experience of rotating nursing students

Objective To explore rotating nursing students′ feelings and experience of patients′ postoperative prone position during their practice in department of ophthalmic surgery, so as to make them more considerate about the patients′ pain and difficulty out of transference, more patient to the patients, and thus increase patients′ comfort and satisfaction. Methods Hermeneutic phenomenological method in qualitative research was adopted. Every rotating nursing student, during the rotation, spent 40 min experiencing the prone position, and 12 were interviewed fully by researchers about their actual feelings and thoughts. Results With generic analysis, after repeated introspection, comparison and induction, four major themes were extracted: comfort level of the prone position was lower than expected; existing prone position equipments needed to be improved; nursing students were lack of patience to the prone-position patients; clinical teaching methods of nursing needed to be improved. Conclusions By experiential teaching, nursing students are fully aware of the discomfort of prone position and shortcomings of equipments, which help them to be more empathetic and more patient to the patients. Key words: Prone position; Transference, psychology; Rotating nursing students; Vitreoretinal diseases; Experiential teaching; Qualitative research

TEMPORAL INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE FOR A MACULAR HOLE PATIENT UNABLE TO MAINTAIN POSTOPERATIVE PRONE POSITIONING

To report the surgical technique and efficacy of the temporal inverted internal limiting membrane (ILM) flap technique for a patient with an idiopathic macular hole (MH) who is unable to maintain postoperative prone positioning. Case report. A 73-year-old man with a Stage III MH in his left eye was scheduled to undergo surgery. Owing to his inability to maintain postoperative prone positioning for continuous placement of a transdermal bladder catheter after radical cystoprostatectomy to treat urinary bladder cancer, he underwent pars plana vitrectomy combined with the temporal inverted ILM flap technique and intraocular sulfur hexafluoride gas tamponade. The technique included ILM peeling at a temporal area of the macula to create one 2-disk-diameter semicircular ILM flap and inversion of the ILM flap nasally to cover the MH. Optical coherence tomography showed that MH closure started from the top of the MH just beneath the covered ILM flap; the closure process gradually extended toward the bottom of the MH. The well-aligned fovea recovered in 5 weeks postoperatively. The visual acuity was 20/200 preoperatively and improved to 20/50 postoperatively. The temporal inverted ILM flap technique, a simple surgery to treat MHs, provides scaffolding for retinal gliosis and may facilitate bridge formation between the walls of the MH beneath the flap. The procedure may be a good option to achieve MH closure without postoperative prone positioning.

Macular Hole Surgery Without Postoperative Prone Position and Spectral-Domain Optical Coherence Tomography Imaging in Gas-Filled Eyes

Background: To evaluate whether spectral-domain optical coherence tomography (SD-OCT) can be used to determine if macular hole (MH) closure occurred in gas-filled eyes without postoperative face-down positioning. Design: Interventional case series, university hospital setting. Participants: We included 19 eyes of 19 MH patients who underwent vitrectomy with SF 6 gas tamponade without postoperative face-down positioning. Methods: Vitrectomy with SF 6 gas tamponade was performed for MH without face-down positioning. The MHs of all patients were evaluated using SD-OCT before and at 3 hours after surgery; daily until confirming the MH status; and at 1 and 3 months postoperatively. Main Outcome Measures: Detection of MH closure. Results: Three hours after surgery, no interpretable images were obtained for any of the 19 eyes. On postoperative day (POD) 1, sufficiently clear images were obtained by SD-OCT to determine MH closure in 10 eyes, 16 eyes on POD 2, and 18 eyes on POD 3. Clear images of the remaining eye were not obtained until POD 5, likely due to pupillary capture of the intraocular lens. All MHs closed after the first surgery. Conclusions: Hole closure can be precisely determined by POD 5 using SD-OCT. If SD-OCT images through gas reveal that the hole is still open, then face-down positioning should be used so that residual gas in the vitreous cavity can close the hole, or a second vitrectomy should be planned.

Sub-internal limiting membrane hemorrhage treated with intravitreal tissue plasminogen activator followed by octafluoropropane gas injection

Sub-internal limiting membrane (sub-ILM) hemorrhage is a relatively rare disease which is associated with different etiologies and often leads to loss of visual acuity. We report two cases of sub-ILM hemorrhage, both confirmed by optical coherence tomography (OCT) and treated with an intravitreal injection of tissue plasminogen activator (tPA) followed by an octafluoropropane (C3F8) pneumopexy and a strict postoperative prone positioning. The hemorrhage was totally resolved and complete visual recovery was achieved in both cases. We found tPA hemolysis with C3F8 pneumopexy to be a safe and effective method for treating sub-ILM hemorrhage.

Operative Behandlung des chronischen Makulaödems durch eine Kombinationstherapie

The treatment of therapy-resistent chronic macular oedema remains a challenge. Therefore a combination therapy, consisting of medical, biological and mechanical components was assessed. A surgical treatment was performed in 35 eyes (34 patients) with chronic and therapy-resistant macular oedema, resulting from diabetic maculopathy (n = 25), vitreoretinal traction (n = 7) or following a retinal venous occlusion (n = 3). An intravitreal injection of bevacizumab was given on the day before surgery, consisting of pars plana vitrectomy with ILM peeling with Brilliant Blue G (BBG), as well as an air tamponade combined with postoperative prone positioning. The visual function and the central retinal thickness were measured in follow-up. Functionally, the visual acuity could be stabilised to an average of 0.18 and macular oedema was reduced in most patients. Anatomically, a significant reduction in central macular thickness by 193 µm (29 %), from 598 µm to 405 µm (p < 0.001), and a regression in the intraretinal cystoid changes were observed. No significant complications occurred, whereas in 6 patients additional consecutive treatment was necessary. A stabilisation of the visual acuity and an improvement in the structural retinal situation could be achieved by an elaborate combination therapy, based on a pharmacological, a biological and a mechanical approach. Long-term follow-up and consecutive supplementary treatments are necessary to ensure the functional stability.

Tapping of Macular Hole Edges: The Outcomes of a Novel Technique for Large Macular Holes.

To describe the novel technique of tapping macular hole edges for holes with low macular hole index (MHI) and assess its outcomes. A prospective interventional study. Twenty-eight consecutive eyes with idiopathic large macular holes (MHI < 0.5) were enrolled. A standardized surgical protocol was performed using vitrectomy with brilliant blue G dye-assisted large internal limiting membrane peeling, intraocular gas tamponade with 18% C3F8, and strict postoperative prone positioning for 5 days. Tapping of macular hole edges was performed on all sides using 23-gauge GreenTip soft tip cannula. Hole closure was examined postoperatively using optical coherence tomography. There were 16 females and 12 males aged 63 ± 14.38 years. The mean MHI was 0.32. Hole closure was seen in 25 eyes (89.29%). MHI was less than 0.25 in the 3 eyes with failed macular hole surgery. Epiretinal membrance (ERM) was present in 22 eyes (78.57%). The presence of ERM did not correlate with hole closure (P = 1.00). Continuity of external limiting membrane was a better predictor of functional success than inner segment/outer segment continuity (P < 0.05). Type I hole closure was seen in 20 (80%) of 25 eyes while the remaining 5 eyes (20%) had type II hole closure on optical coherence tomography. Corrected distance visual acuity improved significantly from 0.86 ± 0.2 logMAR preoperatively 0.43 ± 0.22 logMAR postoperatively (P < 0.0001). Newer technique of tapping macular hole edges provides acceptable anatomical and functional success rates even in large macular holes (MHI< 0.5).

Application of high-density silicone oil in complex retinal detachment surgery

The rapid development of micro-invasive vitrectomy bring the good news for the majority of patients suffering from retinal detachment.Many previously untreatable complex retinal,detachment could be anatomic reattached,postoperative visual acuity could be improved.Vitreous substitute for good efficacy of vitreous surgery and improvements in technology has a very important significance.Currently used materials,such as silicone oil and C3 F8 were lighter in proportion than water,and postoperative prone position was necessary to maintain.The high-density silicone oil,can make an effective top pressure on the retina.In this review,the physical and chemical properties of high-density silicone oil,clinical application,treatment and complications were overviewed. Key words: High-density silicone oil ; Retinal detachment, complex

Treatment of multilevel macular hemorrhage secondary to retinal arterial macroaneurysm with submacular tissue plasminogen activator

To evaluate the efficacy of pars plana vitrectomy (PPV) followed by internal limiting membrane (ILM) removal and injection of subretinal recombinant tissue plasminogen activator (rtPA)-assisted pneumatic displacement in eyes with massive multilevel macular hemorrhage caused by ruptured retinal arterial macroaneurysm (RAMA). Four eyes of 4 patients treated with PPV for recent (</= 7 days) macular hemorrhage at both beneath the ILM and subretinal space involving the center of the fovea caused by RAMA were included in the study. In each case, following PPV, ILM removal, subretinal injection of rtPA (12.5 µg/0.1 mL), and fluid-air exchange with postoperative prone positioning was performed. Optical coherence tomography (OCT) examination was performed at the initial and the follow-up visits. Duration of symptoms ranged from 3 to 7 days (average, 4.5±1.9 days). Preoperative visual acuity ranged from hand motions to 20/800. Follow-up ranged from 6 to 18 months (average, 13±5.2 months). The postoperative visual acuity improved in all eyes and ranged from 20/100 to 20/30 (mean, 20/50). At the final visit, OCT examination revealed well-preserved foveal structure in all eyes. Mild nuclear sclerosis developed in one eye. Pars plana vitrectomy followed by ILM removal and injection of subretinal rtPA-assisted pneumatic displacement appears to be effective in both improving visual acuity and preserving the foveal structure in eyes with recent massive multilevel macular hemorrhage secondary to RAMA.

Successful closure of large blunt macular chorioretinal rupture: a case report

The authors present a rare case of large chorioretinal rupture caused by blunt traumatic injury of the globe. A 22-year-old woman sustained a blunt injury to her left eye. The best-corrected Snellen visual acuity was 2/20 in her left eye, and hyphema and vitreous hemorrhage were noted. The day after the injury occurred the vitreous hemorrhage had disappeared. Fundus examination revealed a crescent-shaped retinal rupture three disc diameters in size near the macula, and a choroidal rupture six disc diameters in size that was over the vascular arcade. Three days after the injury, vitrectomy with internal limiting membrane peeling was performed. Postoperative prone positioning was maintained for 4 days. Five days postoperatively, closure of the ruptured retina was confirmed. The visual acuity improved to 16/20 4 months after surgery and this was maintained over a 48-month period. In conclusion, early vitrectomy with internal limiting membrane peeling after injury was effective for a case involving severe blunt chorioretinal rupture with closed globe injury.

Surgical macular decompression for macular edema in retinal vein occlusion.

Recently, a number of surgical and laser approaches have been used to improve visual outcome in cases of central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO). Intravitreal steroid injection alone appears to offer only temporary improvement at best. Radial optic neurotomy for CRVO and arteriovenous adventitial sheathotomy for BRVO are the most frequently utilized surgical procedures for these conditions, but evidence regarding efficacy is still lacking. We have suggested that macular decompression by internal limiting membrane (ILM) peeling may reduce macular edema and hemorrhage and improve visual acuity by relieving elevated intraretinal tissue pressure and facilitating egress of blood and extracellular fluid out of inner retinal layers into the vitrectomized vitreous cavity. 50 cases of severe visual loss due to macular edema caused by CRVO or BRVO, not eligible for laser photocoagulation, underwent pars plana vitrectomy with removal of preretinal hyaloid, peeling of the ILM stained with indocyanine green dye, air-fluid exchange, and postoperative prone positioning. In all cases, intraretinal blood and retinal thickening diminished within 6 weeks of surgery. Visual acuity improved in 87% of CRVO cases and 68% of BRVO cases. Vision improved and stabilized at 39 days after surgery. Average improvement was 2.6 lines with a 6-line improvement in 1 case. There was no difference in outcome between cases with ischemic or nonischemic features on fluorescein angiography. Macular decompression using vitrectomy and ILM peeling is effective in the treatment of severe visual loss due to macular edema in CRVO and in those BRVO cases that do not qualify for laser photocoagulation.

Pars plana vitrectomy and internal limiting membrane peeling for macular edema secondary to retinal vein occlusion

Purpose:To evaluate the effects of vitrectomy and internal limiting membrane peeling for treatment of macular edema secondary to retinal vein occlusion (RVO).Methods:Nine cases of visual loss due to macular edema caused by central retinal vein occlusion or branch retinal vein occlusion underwent pars plana vitrectomy with removal of the preretinal hyaloid, peeling of the internal limiting membrane stained with indocyanine green dye, air–fluid exchange, and postoperative prone positioning. Best-corrected visual acuity (BCVA) and central foveal thickness by optical coherence tomography were measured pre- and postoperatively then compared to assess the outcome of surgery.Results:In all cases intraretinal blood and retinal thickening diminished within 2 months of surgery. Visual acuity improved in all of the central retinal vein occlusion cases and 3/6 branch retinal vein occlusion cases. The decrease in macular thickness was statistically significant (mean postoperative macular thickness 361 ± 61.1 versus mean preoperative macular thickness 563.9 ± 90.0, P = 0.001, t-test). The improvement in BCVA was not statistically significant (mean preoperative BCVA in LogMAR 1.23 ± 0.29 versus mean postoperative BCVA in LogMAR 1.06 ± 0.49, P = 0.09, t-test).Conclusion:In eyes with macular edema secondary to RVO, pars plana vitrectomy with internal limiting membrane peeling can resolve macular edema, but the improvement in BCVA was not statistically significant in this study.

Subretinal recombinant tissue plasminogen activator and pneumatic displacement for the management of subretinal hemorrhage occurring after anti-VEGF injections for wet AMD

We describe three cases of submacular hemorrhage that occurred two to four days after anti-VEGF intravitreal injection for occult choroidal neovascularisation in age-related macular degeneration and their management with 25 gauge pars plana vitrectomy with injection of subretinal recombinant tissue plasminogen activator (rTPA) followed by fluid-air exchange and postoperative prone position. Vitrectomy, subretinal rTPA injection and fluid-gas exchange apply as a safe and effective treatment in these cases. Functional results seem to be positive especially if surgical treatment is promptly performed.

Long-term outcomes of Oxane Hd as intraocular tamponade in the treatment of complicated retinal detachment

To evaluate the efficacy and safety of heavy silicone oil Oxane Hd as intraocular tamponade in the treatment of complicated retinal detachment (RD). Forty eyes of 40 patients with complicated RD were recruited for this prospective study. Inclusion criteria were proliferative vitreoretinopathy grade > or = CP2, mainly inferior and posterior retinal breaks, or superior retinal breaks with patient's inability to posture. Oxane Hd was used as intraocular tamponade. The retinal status, the best-corrected visual acuity (BCVA) results, and any complications were observed. The mean duration of Oxane Hd endotamponade was 87.9 +/- 10.4 days, and the mean follow-up time after Oxane Hd removal was 438.1 +/- 153.7 days. The primary anatomical success rate after Oxane Hd removal was 87.5%, and with further intervention 97.5%. The BCVA significantly improved, from mean logMAR 2.12 +/- 0.60 to 1.38 +/- 0.59 (P < 0.001). The postoperative complications included temporary inflammatory reaction, moderately high intraocular pressure, heavy silicone oil emulsification, lens opacity and retinal proliferative membranes. Without a requirement for postoperative prone position, heavy silicone oil Oxane Hd is effective and safe for the treatment of complicated RD with inferior and posterior breaks. Larger groups and a longer follow-up period will be included to further evaluate the efficacy with Oxane Hd in superior retinal breaks.