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Frank Brodie, Kelly Woo, Hyuck Choo, Robert Grubbs; Improving Post-Operative Positioning Compliance: A Novel Device. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5836.
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© ARVO (1962-2015); The Authors (2016-present)
The use of intraocular gas for repair of retinal detachments and macular holes is a mainstay of vitreoretinal surgery. Post-operatively, the patient is positioned so that the gas bubble is in apposition to the retinal pigment epithelium. In order to ensure correct position of the gas bubble against these breaks, patients are instructed in specific postoperative positioning of their head. In spite of instructing patients on the importance of proper head positioning after use of intraocular gas, numerous studies have shown patients are not compliant with the prescribed regimen. Our novel positioning device provides real time alerts when the bubble is out of position in the eye and allows patients to correct their position.
A prototype of the post operative positioning device was built and tested to determine fidelity between sensor alert and bubble position in a model eye. The site of retinal break was marked in the model eye and gas bubbles were tested in three axes of rotation at progressive amounts of deviation. Each of these was repeated with three different intraocular bubble sizes, representing the absorption of CF6 gas at post-operative day 1, 3 and 5. Agreement between the positioning sensor and position of the gas bubble in the model eye was the primary outcome measure.
The positioning sensor showed excellent fidelity with actual location of the gas bubble in the model eye. The sensitivity of the sensor in detecting the bubble being off the break in the model eye was 100% with a specificity of 86%.
Our novel post operative positioning device proved highly reliable in detecting when the intraocular bubble was off the break. Having shown that our sensor can accurately detect when the intraocular gas bubble is out of position in vitro, we plan to proceed with in vivo testing of not only sensor fidelity, but how it affects patient behavior and ultimately outcomes in the post operative period. Future designs for our sensor will miniaturize the device, provide wireless connectivity for tracking compliance, adjusting sensitivity and providing audible and vibrating alerts.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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