Optical coherence tomography evaluation of patients with macula-off retinal detachment after different postoperative posturing: a randomized pilot study

Acta Ophthalmol. 2017 Aug;95(5):e379-e384. doi: 10.1111/aos.13397. Epub 2017 Apr 26.

Abstract

Purpose: To assess the presence of outer and inner retinal folds (RFs) and drop-out of the ellipsoid zone (EZ) occurring after surgical repair of macula-off rhegmatogenous retinal detachment (RRD) with different postoperative posture and preoperative use of adjuvant perfluorocarbon liquid (PFCO).

Methods: In this prospective study, 56 eyes of 56 consecutive patients affected by RRD were subjected to 23- or 25-gauge pars plana vitrectomy (PPV). The patients were randomized in four groups (14 prone 5 hr without PFCO, 14 supine 5 hr without PFCO, 14 prone 5 hr with PFCO and 14 supine 5 hr with PFCO) and followed up with spectral domain optical coherence tomography (SD-OCT).

Results: Spectral domain optical coherence tomography (SD-OCT) was recorded before surgery, at days 30 and 90 to detect the presence of outer RFs, inner RFs and drop-out of EZ and to follow their variation over time. No statistical significance was found in our groups for outer RFs, inner RFs, drop-out of EZ formation and evolution. The postoperative best-corrected visual acuity (BCVA) improved in all groups (mean preoperative BCVA 1.47 logMar ± 0.19, mean postoperative BCVA 0.27 logMar ± 0.11, p < 0.01), without statistical variations between the four groups in BCVA after surgery.

Conclusion: The use of adjuvant and variation in postoperative position did not change the risk of presenting outer RFs, inner RFs and drop-out of EZ after RRD.

Keywords: optical coherence tomography; pars plana vitrectomy; postoperative posturing; retinal detachment; retinal folds.

MeSH terms

  • Aged
  • Endotamponade / methods
  • Female
  • Fluorocarbons / administration & dosage
  • Humans
  • Macula Lutea / pathology*
  • Male
  • Middle Aged
  • Patient Positioning / methods*
  • Pilot Projects
  • Postoperative Period
  • Posture*
  • Prospective Studies
  • Retinal Detachment / diagnosis*
  • Retinal Detachment / surgery
  • Single-Blind Method
  • Tomography, Optical Coherence / methods*
  • Visual Acuity*
  • Vitrectomy / methods*

Substances

  • Fluorocarbons