Vitrectomy without prone positioning for rhegmatogenous retinal detachments in eyes with inferior retinal breaks
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. This retrospective cohort study included 142 eyes of 142 patients with a primary RRD. All patient...
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| creator | Shiraki, Nobuhiko Sakimoto, Susumu Sakaguchi, Hirokazu Nishida, Kentaro Nishida, Kohji Kamei, Motohiro |
| description | 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.
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.
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.
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. |
| doi_str_mv | 10.1371/journal.pone.0191531 |
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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.
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.
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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0191531</identifier><identifier>PMID: 29373582</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acuity ; Biology and Life Sciences ; Care and treatment ; Cataracts ; Complications ; Eye ; Eye (anatomy) ; Eye surgery ; Laboratories ; Medicine ; Medicine and Health Sciences ; Patient outcomes ; Patients ; Prone position ; Retina ; Retinal detachment ; Sulfur ; Sulfur hexafluoride ; Surgeons ; Tamponade ; University graduates ; Visual acuity ; Vitrectomy</subject><ispartof>PloS one, 2018-01, Vol.13 (1), p.e0191531-e0191531</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>2018 Shiraki et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2018 Shiraki et al 2018 Shiraki et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-213bf07e70f904e1bba9d3afea63b68505290a564ecbe1432319c3dd4d3e79813</citedby><cites>FETCH-LOGICAL-c692t-213bf07e70f904e1bba9d3afea63b68505290a564ecbe1432319c3dd4d3e79813</cites><orcidid>0000-0003-2603-1043</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5786309/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5786309/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,725,778,782,862,883,2098,2917,23849,27907,27908,53774,53776,79351,79352</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29373582$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Vavvas, Demetrios G.</contributor><creatorcontrib>Shiraki, Nobuhiko</creatorcontrib><creatorcontrib>Sakimoto, Susumu</creatorcontrib><creatorcontrib>Sakaguchi, Hirokazu</creatorcontrib><creatorcontrib>Nishida, Kentaro</creatorcontrib><creatorcontrib>Nishida, Kohji</creatorcontrib><creatorcontrib>Kamei, Motohiro</creatorcontrib><title>Vitrectomy without prone positioning for rhegmatogenous retinal detachments in eyes with inferior retinal breaks</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>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.
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.
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.
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.</description><subject>Acuity</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Cataracts</subject><subject>Complications</subject><subject>Eye</subject><subject>Eye (anatomy)</subject><subject>Eye surgery</subject><subject>Laboratories</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Prone position</subject><subject>Retina</subject><subject>Retinal detachment</subject><subject>Sulfur</subject><subject>Sulfur hexafluoride</subject><subject>Surgeons</subject><subject>Tamponade</subject><subject>University graduates</subject><subject>Visual 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without prone positioning for rhegmatogenous retinal detachments in eyes with inferior retinal breaks</title><author>Shiraki, Nobuhiko ; Sakimoto, Susumu ; Sakaguchi, Hirokazu ; Nishida, Kentaro ; Nishida, Kohji ; Kamei, Motohiro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-213bf07e70f904e1bba9d3afea63b68505290a564ecbe1432319c3dd4d3e79813</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Acuity</topic><topic>Biology and Life Sciences</topic><topic>Care and treatment</topic><topic>Cataracts</topic><topic>Complications</topic><topic>Eye</topic><topic>Eye (anatomy)</topic><topic>Eye surgery</topic><topic>Laboratories</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Prone position</topic><topic>Retina</topic><topic>Retinal detachment</topic><topic>Sulfur</topic><topic>Sulfur 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Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shiraki, Nobuhiko</au><au>Sakimoto, Susumu</au><au>Sakaguchi, Hirokazu</au><au>Nishida, Kentaro</au><au>Nishida, Kohji</au><au>Kamei, Motohiro</au><au>Vavvas, Demetrios G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Vitrectomy without prone positioning for rhegmatogenous retinal detachments in eyes with inferior retinal breaks</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-01-26</date><risdate>2018</risdate><volume>13</volume><issue>1</issue><spage>e0191531</spage><epage>e0191531</epage><pages>e0191531-e0191531</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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.
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.
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.
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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>29373582</pmid><doi>10.1371/journal.pone.0191531</doi><tpages>e0191531</tpages><orcidid>https://orcid.org/0000-0003-2603-1043</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Acuity Biology and Life Sciences Care and treatment Cataracts Complications Eye Eye (anatomy) Eye surgery Laboratories Medicine Medicine and Health Sciences Patient outcomes Patients Prone position Retina Retinal detachment Sulfur Sulfur hexafluoride Surgeons Tamponade University graduates Visual acuity Vitrectomy |
| title | Vitrectomy without prone positioning for rhegmatogenous retinal detachments in eyes with inferior retinal breaks |
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