July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
The Posturing after Retinal Detachment (PostRD) Trial
Author Affiliations & Notes
  • Edward Casswell
    Moorfields Eye Hospital, United Kingdom
  • David Yorston
    Tennant Institute of Ophthalmology, London, United Kingdom
  • Ed Lee
    Moorfields Eye Hospital, United Kingdom
  • Tjebo Heeren
    Moorfields Eye Hospital, United Kingdom
  • Nicola Harris
    Moorfields Eye Hospital, United Kingdom
  • Tapiwa Zvobgo
    Moorfields Eye Hospital, United Kingdom
  • Sonali Tarafdar
    Moorfields Eye Hospital, United Kingdom
  • Wen Xing
    Moorfields Eye Hospital, United Kingdom
  • Catey Bunce
    Moorfields Eye Hospital, United Kingdom
  • David G Charteris
    Moorfields Eye Hospital, United Kingdom
  • Footnotes
    Commercial Relationships   Edward Casswell, None; David Yorston, None; Ed Lee, None; Tjebo Heeren, None; Nicola Harris, None; Tapiwa Zvobgo, None; Sonali Tarafdar, None; Wen Xing, None; Catey Bunce, None; David Charteris, None
  • Footnotes
    Support  Royal College of Surgeons (Edinburgh); Special Trustees of Moorfields Eye Hospital
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 6421. doi:
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      Edward Casswell, David Yorston, Ed Lee, Tjebo Heeren, Nicola Harris, Tapiwa Zvobgo, Sonali Tarafdar, Wen Xing, Catey Bunce, David G Charteris; The Posturing after Retinal Detachment (PostRD) Trial. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6421.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : A randomised controlled trial to evaluate the effect of face-down posturing on retinal displacement and distortion following macula-involving retinal detachment repair.

Methods : Prospective, single-masked randomised controlled trial across two sites (Moorfields Eye Hospital, London & Tennent Institute of Ophthalmology, Glasgow). 262 patients with macula-involving retinal detachments undergoing repair with vitrectomy and gas tamponade were randomised (1:1) to one of two post-operative posturing regimes: (a) face-down or (b) position to ‘support-the-break’ for a 24-hour period following surgery. Primary outcome was the proportion of patients with retinal displacement detected on fundus autofluorescence imaging in each group at 6 months post-operatively. Secondary outcomes included degree of retinal translocation on FAF imaging, corrected visual acuity, objective distortion score (D chart) and quality of life questionnaire scores 6 months post-operatively.

Results : 262 patients were randomised (241 Moorfields & 21 Tennent Institute), with 41 withdrawals during the study period. At 6 months, retinal displacement was detected in 34% of the face down group vs 47% of the support-the-break group (p=0.2). If ungradable images were excluded, this difference was statistically significant (n=203, p=0.05). At 8 weeks, retinal displacement was detected in 35% of the face down group vs 52% of the support-the-break group (p=0.036). There was no statically significant difference in subjective distortion (59% vs 53%), objective D Chart distortion scores or corrected visual acuity between the two groups at 6 months. Adverse events: retinal re-detachment rate was the same in both groups (12.2%). Retinal folds (outer retina & full thickness retinal folds) were less commonly seen in the face down group (5.3%) vs the support-the-break group (13.5%) (p=0.03).

Conclusions : Face down posturing reduced the risk of retinal displacement and retinal folds following macula-involving retinal detachment repair, but had no effect of visual acuity, subjective or objective distortion.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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