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Radwan Ajlan, Jordan Isenberg, Ghassan Cordahi, Renaud Duval, Sébastien Olivier, Flavio Rezende; Primary rhegmatogenous retinal detachment with inferior retinal breaks: 1 day vs 7 days postoperative prone positioning results.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1038. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
The purpose of our study is to compare the primary anatomical success rate of pars plana vitrectomy, 360° peripheral endolaser and 15% C3F8 gas tamponade with 24-hours prone positioning in patients with uncomplicated rhegmatogenous detachment and inferior retinal breaks, to identical patients with 1 week postoperative prone positioning.
Records of 5500 patients who underwent pars plana vitrectomy between 2008 and 2015 were retrieved. Collected data included age, gender, number of retinal quadrants with retinal breaks, number of retinal breaks, visual acuity (on presentation and at 3 months post-operative), macula status on presentation (attached or detached), phakic status (phakic, pseudophakic, or aphakic), and primary anatomical success (at 1 and 3 months post-operative).
270 patients met the study inclusion criteria. On the 24-hours positioning arm, 183 patients met the study inclusion with an overall anatomical success rate of 96.2% at 1 month and 83.6% at 3 months. Primary anatomical success in phakic eyes (58 eyes) was 96.6% at 1 month and 81% at 3 months post-operative. In the pseudophakic/aphakic group (125 eyes), primary anatomical success was achieved in 96% and 84.8% at 1 month and at 3 months post-operative, respectively. In the 1-week positioning group, 87 patients met the inclusion criteria, with an overall anatomical success rate of 93% at 1 month and 79% at 3 months. Primary anatomical success in phakic eyes (21 eyes) was 95% at 1 month and 76% at 3 months post-operative. In the pseudophakic/aphakic group (66 eyes), primary anatomical success was achieved in 92.4% and 80% at 1 month and at 3 months post-operative, respectively. Both positioning groups did not show statistical difference in outcome at 1 month (p-value= 0.7) or at 3 months (p-value= 0.39).
This retrospective study demonstrated that in patients with uncomplicated rhegmatogenous retinal detachment and inferior retinal breaks, pars plana vitrectomy, combined with 360° endolaser, 15% C3F8 gas, and limited (24-hours) prone positioning may have similar results when compared with 1 week postoperative positioning. Larger prospective studies are warranted to further our understanding about the role of limited prone positioning in inferior retinal detachment management.
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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