Supine positioning after vitrectomy for rhegmatogenous retinal detachments with inferior retinal breaks
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nternational Journal of Retina and Vitreous
(2020) 6:41
Open Access
ORIGINAL ARTICLE
Supine positioning after vitrectomy for rhegmatogenous retinal detachments with inferior retinal breaks Amr Mohammed Elsayed Abdelkader1* and Hossam Youssef Abouelkheir2
Abstract Background: To evaluate the effectiveness of face up position (FUP) following pars plana vitrectomy (PPV) and silicone oil injection in cases of rhegmatogenous retinal detachment (RRD) with multiple peripheral and inferior breaks. Method: Thirty-two eyes of 32 patients with RRD due to multiple peripheral breaks were managed with PPV and silicone oil as endotamponade. Postoperatively, all patients were instructed to assume face up (supine) position for at least 10 days. Silicone oil was removed 3 to 6 months postoperatively in eyes with attached retina and the patients were followed up for 6 months. Results: Thirty eyes (94%) got a successful attachment of the retina and remained attached after silicone oil removal. One case showed lower redetachment under silicone oil while the other case showed recurrent RRD after silicone oil removal. Conclusion: Although postoperative FUP is not a popular one, it is effective in the treatment of RRD with peripheral breaks whatever the number or the distribution of these breaks. This may in some way or another change the traditional trends of postoperative positioning after vitrectomy for RRD. Keywords: Face up position, Pars plana vitrectomy, Retinal breaks, Rhegmatogenous retinal detachment, Silicone oil Background Silicone oil is a synthetic polymer that proved to be a valuable tool in the treatment of rhegmatogenous retinal detachment (RRD). Owing to its low specific gravity (0.97 g/ml), the fluid in the vitreous cavity goes down and the silicone bubble floats upwards [1]. Postoperatively the patient is positioned in a way that makes the surface of the bubble close the retinal breaks. Face down position (FDP) remains a common decubitus described to the patients after vitrectomy [2–4] Actually, this is of limited value as the main function of the intraocular
tamponading agent is to occlude retinal breaks till firm adhesion is created by retionpexy and the remaining retina will flatten even if a residual subretinal fluid is present [5]. So, it is more important to tamponade or plug the breaks rather than to push the retina backwards towards the posterior pole of the eye. An ideal position to achieve this goal is to direct the patient to lay supine with his face up as long as there is no posterior breaks. The aim of this work is to determine whether maintaining FUP after PPV and silicone injection for RRD with peripheral breaks would be beneficial or not.
*Correspondence: [email protected] 1 Department of ophthalmology, Lecturer of ophthalmology, Mansoura ophthalmic center, faculty of medicine, Mansoura university, Mansoura, Egypt Full list of author information is available at the end of the article
Patients and methods This study was conducted in Mansoura university ophthalmic center from August 2
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