Postoperative positioning regimens in adults who undergo retinal detachment repair: A systematic review.
Sverdlichenko Irina, Lim Michelle, Popovic Marko M, Pimentel Miguel Cruz, Kertes Peter J, Muni Rajeev H
AI Summary
This review of retinal detachment repair positioning found prone positioning had lower reattachment rates than alternative positions, with complication trade-offs, guiding personalized post-op care.
Abstract
Little is known about the comparative benefit of different positioning regimens in rhegmatogenous retinal detachment (RRD) repair. We compared outcomes of different postoperative posturing regimens following pars plana vitrectomy (PPV). MEDLINE, EMBASE, and Cochrane CENTRAL were searched from 2000 to February 2022 for original studies that compared at least 2 postoperative posturing regimens in adults who underwent PPV for RRD. Seven comparative studies and 703 eyes were included. There were no differences in final visual acuity between posturing regimens. Single-procedure reattachment rates were higher with alternative positioning compared to prone positioning in patients with inferior breaks. Prone and alternative positioning were associated with similar risks of complications. In contrast, prone posturing had a higher risk of neck pain and intraocular pressure elevation than support-the-break, which had a greater risk of retinal displacement, retinal folds, and binocular diplopia. Immediate prone positioning was superior to delayed prone for the risk of retinal displacement. The present review shows that prone positioning was associated with a lower reattachment rate than alternative positioning. There were trade-offs in complications between prone and support-the-break positioning. Retinal displacement could be mitigated when prone positioning is maintained immediately after surgery.
MeSH Terms
Shields Classification
Key Concepts6
In a systematic review of 7 comparative studies and 703 eyes, there were no differences in final visual acuity between different postoperative posturing regimens following pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD).
In a systematic review of 7 comparative studies and 703 eyes, single-procedure reattachment rates were higher with alternative positioning compared to prone positioning in patients with inferior breaks following pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD).
In a systematic review of 7 comparative studies and 703 eyes, prone and alternative positioning were associated with similar risks of complications following pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD).
In a systematic review of 7 comparative studies and 703 eyes, prone posturing had a higher risk of neck pain and intraocular pressure elevation than support-the-break positioning following pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD).
In a systematic review of 7 comparative studies and 703 eyes, support-the-break positioning had a greater risk of retinal displacement, retinal folds, and binocular diplopia than prone posturing following pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD).
In a systematic review of 7 comparative studies and 703 eyes, immediate prone positioning was superior to delayed prone positioning for the risk of retinal displacement following pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD).
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