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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...

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Autores principales: Shiraki, Nobuhiko, Sakimoto, Susumu, Sakaguchi, Hirokazu, Nishida, Kentaro, Nishida, Kohji, Kamei, Motohiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2018
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.
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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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