Dr. Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Retina. 2024 Jul 1;44(7):1150-1156. doi: 10.1097/IAE.0000000000004075.
To compare Supine versus Prone positioning in fresh rhegmatogenous retinal detachments treated with vitrectomy and gas tamponade.
This was a prospective randomized controlled trial of 72 eyes with fresh rhegmatogenous retinal detachment that underwent 25-gauge vitrectomy: 37 eyes were allotted supine position and 35 were allotted prone position. Cases were evaluated for single-surgery reattachment rates, best-corrected visual acuity, intraocular pressure, cataract formation, and any complications. The patients were followed up for a period of 3 months.
Both groups had similar demographics, and no significant difference was found between the two groups in terms of extent of retinal detachment, position, and number of breaks. The anatomical success after single surgery was 97.3% in the Supine group and 94.3% in the Prone group ( P = 0.609). The best-corrected visual acuity at the end of 3 months was 0.44 ± 0.27 in the Supine group and 0.35 ± 0.27 in the Prone group ( P = 0.119) with a significant increase in best-corrected visual acuity preoperatively from 0.11 ± 0.22 and 0.13 ± 0.22 in Supine and Prone groups, respectively ( P = <0.001). The intraocular pressure in the two groups was comparable at each follow-up. The rates of cataract formation were also similar in the two groups-60% and 53.8% in Supine and Prone groups, respectively ( P = 1.00). Complications such as spikes in intraocular pressure, epiretinal membrane formation, and cystoid macular edema were similar in both groups.
Rates of retinal reattachment were comparable in both groups showing that supine position is equally safe and effective for adequate tamponade.
比较玻璃体切除联合气液交换治疗新鲜孔源性视网膜脱离时采用仰卧位与俯卧位的效果。
这是一项前瞻性随机对照试验，纳入了 72 例新鲜孔源性视网膜脱离患者，均接受 25G 玻璃体切除术治疗：37 例患者采用仰卧位，35 例患者采用俯卧位。评估两组患者的一次手术成功率、最佳矫正视力、眼压、白内障形成及其他并发症。所有患者均随访 3 个月。
两组患者的一般资料相似，两组间视网膜脱离范围、体位及裂孔数量无显著差异。仰卧位组一次手术成功率为 97.3%，俯卧位组为 94.3%（P=0.609）。3 个月时，仰卧位组最佳矫正视力为 0.44±0.27，俯卧位组为 0.35±0.27（P=0.119），两组术前最佳矫正视力分别为 0.11±0.22 和 0.13±0.22，均较术前显著提高（P＜0.001）。两组各随访时间点的眼压均无显著差异。两组白内障发生率相似，分别为 60%和 53.8%（P=1.00）。两组间眼压升高、视网膜前膜形成及黄斑囊样水肿等并发症的发生率也相似。
两组视网膜复位率相当，表明仰卧位对充分填塞同样安全有效。
