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Vitrectomy without prone positioning for rhegmatogenous retinal detachments in eyes with inferior retinal breaks
PURPOSE: To 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. METHODS: This retrospective cohort study included 142 eyes of 142 patients with a primar...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5786309/ https://www.ncbi.nlm.nih.gov/pubmed/29373582 http://dx.doi.org/10.1371/journal.pone.0191531 |
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author | Shiraki, Nobuhiko Sakimoto, Susumu Sakaguchi, Hirokazu Nishida, Kentaro Nishida, Kohji Kamei, Motohiro |
author_facet | Shiraki, Nobuhiko Sakimoto, Susumu Sakaguchi, Hirokazu Nishida, Kentaro Nishida, Kohji Kamei, Motohiro |
author_sort | Shiraki, Nobuhiko |
collection | PubMed |
description | PURPOSE: To 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. METHODS: This 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. RESULTS: 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 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. CONCLUSIONS: PPV 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. |
format | Online Article Text |
id | pubmed-5786309 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-57863092018-02-09 Vitrectomy without prone positioning for rhegmatogenous retinal detachments in eyes with inferior retinal breaks Shiraki, Nobuhiko Sakimoto, Susumu Sakaguchi, Hirokazu Nishida, Kentaro Nishida, Kohji Kamei, Motohiro PLoS One Research Article PURPOSE: To 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. METHODS: This 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. RESULTS: 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 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. CONCLUSIONS: PPV 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. Public Library of Science 2018-01-26 /pmc/articles/PMC5786309/ /pubmed/29373582 http://dx.doi.org/10.1371/journal.pone.0191531 Text en © 2018 Shiraki et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Shiraki, Nobuhiko Sakimoto, Susumu Sakaguchi, Hirokazu Nishida, Kentaro Nishida, Kohji Kamei, Motohiro Vitrectomy without prone positioning for rhegmatogenous retinal detachments in eyes with inferior retinal breaks |
title | Vitrectomy without prone positioning for rhegmatogenous retinal detachments in eyes with inferior retinal breaks |
title_full | Vitrectomy without prone positioning for rhegmatogenous retinal detachments in eyes with inferior retinal breaks |
title_fullStr | Vitrectomy without prone positioning for rhegmatogenous retinal detachments in eyes with inferior retinal breaks |
title_full_unstemmed | Vitrectomy without prone positioning for rhegmatogenous retinal detachments in eyes with inferior retinal breaks |
title_short | Vitrectomy without prone positioning for rhegmatogenous retinal detachments in eyes with inferior retinal breaks |
title_sort | vitrectomy without prone positioning for rhegmatogenous retinal detachments in eyes with inferior retinal breaks |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5786309/ https://www.ncbi.nlm.nih.gov/pubmed/29373582 http://dx.doi.org/10.1371/journal.pone.0191531 |
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