Face-up vs face-down positioning after rhegmatogenous macula-off retinal detachment surgery: Hypothesis of better recovery

Abstract

Purpose

To evaluate the differences between two distinct patient postoperative positions following rhegmatogenous macula-off retinal detachment surgery.

Methods

In this consecutive clinical study, 26 patients were placed in either the face-up or face-down postoperative position group. Postoperative follow-ups were conducted at 1, 3, and 6 months using type 1 M-CHARTS, best-corrected visual acuity (BCVA), intraocular pressure, and optical coherence tomography imaging to evaluate the functional and anatomical outcomes after surgery.

Results

The average vision recovery at 6 months was 0.35159 +/- 0.30945 logarithm of the minimum angle of resolution (logMAR) for the face-up group and 0.81521+/- 0.46662 logMAR for the face-down group. At 6 months, the average horizontal type 1 M-CHARTS for the face-up group was 0.1615 +/- 0.1710 and 0.2846 +/- 0.2828 for the face-down group; and the average vertical type 1 M-CHARTS was 0.1615 +/- 0.1557 for the face-up group and 0.2846 +/- 0.1725 for the face-down group.

Conclusion

The face-up position demonstrated significant improvement in both metamorphopsia and BCVA, suggesting that slow reattachment of photoreceptors on the retinal pigment epithelium layer can result in better quality of sight recovery.

Further studies with larger sample sizes are warranted to confirm these results.

The study adhered to the guidelines of the Declaration of Helsinki.

Keywords

Retinal detachment vitrectomy scleral buckling metamorphopsia visual acuity.

Get full access to this article

View all access options for this article.

References

Hillier

Felfeli

Berger

, et al. The pneumatic retinopexy versus vitrectomy for the management of primary rhegmatogenous retinal detachment outcomes randomized trial (PIVOT). Ophthalmology 2019; 126: 531–539.

Mitry

Awan

Borooah

, et al. Long-term visual acuity and the duration of macular detachment: findings from a prospective population-based study. Br J Ophthalmol 2013; 97: 149–152.

Diederen

RMH

La Heij

Kessels

AGH

, et al. Scleral buckling surgery after Macula-off retinal detachment. Ophthalmology 2007; 114: 705–709.

Wang

Zhu

, et al. Metamorphopsia after successful retinal detachment surgery: an optical coherence tomography study. Acta Ophthalmol Scand 2005; 83: 168–171.

River

Ben Hur

Steiner

. Reversal of vision metamorphopsia: clinical and anatomical characteristics. Arch Neurol 1998; 55: 1362.

Wolfensberger

Gonvers

. Optical coherence tomography in the evaluation of incomplete visual acuity recovery after macula-off retinal detachments. Graefes Arch Clin Exp Ophthalmol 2002; 240: 85–89.

Crossland

Rubin

. The Amsler chart: absence of evidence is not evidence of absence. Br J Ophthalmol 2007; 91: 391–393.

Schwartz

. Twenty-year follow-up for scleral buckling. Arch Ophthalmol 2002; 120: 325.

Özgür

Esgin

. Macular function of successfully repaired macula-off retinal detachments. Retina 2007; 27: 358–364.

10.

Heimann

Zou

Jandeck

, et al. Primary vitrectomy for rhegmatogenous retinal detachment: an analysis of 512 cases. Graefes Arch Clin Exp Ophthalmol 2006; 244: 69–78.

11.

Internal Limiting Membrane Peeling to Prevent Post-vitrectomy Epiretinal Membrane Development in Retinal Detachment - PubMed [Internet]. [cited 2024 Dec 11];Available from: https://pubmed.ncbi.nlm.nih.gov/27544480/

12.

https://fyra.io. Prophylactic ILM Peeling: When, Why, How? [Internet]. Retina Today. [cited 2024 Dec 11];Available from: https://retinatoday.com/articles/2018-jan-feb/prophylactic-ilm-peeling-when-why-how.

13.

Miller

Rao

Choudhry

, et al. Pockets of subretinal fluid after retinal reattachment surgery: new insights with SD-OCT. Invest Ophthalmol Vis Sci 2012; 53: 5799.

14.

Hagimura

Iida

Suto

, et al. Persistent foveal retinal detachment after successful rhegmatogenous retinal detachment surgery. Am J Ophthalmol 2002; 133: 516–520.

15.

Gibran

Alwitry

Cleary

. Foveal detachment after successful retinal reattachment for macula on rhegmatogeneous retinal detachment: an ocular coherence tomography evaluation. Eye 2006; 20: 1284–1287.

16.

Baba

Hirose

Moriyama

, et al. Tomographic image and visual recovery of acute macula-off rhegmatogenous retinal detachment. Graefes Arch Clin Exp Ophthalmol 2004; 242: 576–581.

17.

Dell’omo

Mura

Lesnik Oberstein

, et al. Early simultaneous fundus autofluorescence and optical coherence tomography features after pars Plana vitrectomy for primary rhegmatogenous retinal detachment. Retina 2012; 32: 719.

18.

Dell’omo

Cifariello

Dell’omol

, et al. Influence of retinal vessel printings on metamorphopsia and retinal architectural abnormalities in eyes with idiopathic macular epiretinal membrane. Invest Ophthalmol Vis Sci 2013; 54: 7803–7811.

19.

Okamoto

Sugiura

Okamoto

, et al. Metamorphopsia and optical coherence tomography findings after rhegmatogenous retinal detachment surgery. Am J Ophthalmol 2014; 157: 214–220.e1.

20.

Schöneberger

Menghesha

, et al. Outcomes of short- versus long-acting gas tamponades in vitrectomy for rhegmatogenous retinal detachment. Int J Retina Vitr 2024; 10: 16.

21.

Schwartz

Flynn Jr

Wang

, et al. Tamponade in surgery for retinal detachment associated with proliferative vitreoretinopathy. Cochrane Database Syst Rev [Internet] 2020 [cited 2024 May 8]; 2020, Available from: http://doi.wiley.com/10.1002/14651858.CD006126.pub4.

22.

Liang

X-M

Jia

Y-H.

Comparison of surgical outcomes in air versus silicone oil tamponade in rhegmatogenous retinal detachment after 25G pars plana vitrectomy. Int J Ophthalmol 2020; 20: 711–714.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB