A comparison of strict face-down position with adjustable position after pars plana vitrectomy and gas tamponade for rhegmatogenous retinal detachment

Objective To compare face-down positioning and adjustable positioning after pars plana vitrectomy for the repair of rhegmatogenous retinal detachment. Methods Sixty-eight patients (68 eyes) with rhegmatogenous retinal detachment were included in this study. All patients received pars plana vitrectomy with long-acting gas for tamponade and then subdivided into 2 groups: 29 were included in a face-down group and 39 were included in the adjustable positioning group. Patients were followed up for 3 months. The outcome was the rate of anatomical retinal reattachment, best-corrected visual acuity and postoperative complications. Results Most of the preoperative baseline characteristics between the two groups were not significantly different. The anatomical success rates after primary surgery were 89.7% and 92.3% for the face-down group and the adjustable positioning group, respectively (P=1.00). Best-corrected visual acuity at the 3-month postoperative visit was 0.74 ± 0.25 for the face-down group and 0.77 ± 0.36 for the adjustable positioning group, respectively (P=0.41). The rates of complications were not statistically different in the two groups. Conclusions Adjustable positioning after pars plana vitrectomy and gas tamponade for rhegmatogenous retinal detachment repair is effective and safe. Face-down positioning seems not to be necessary for all patients with rhegmatogenous retinal detachment. Key words: Vitrectomy; Rhegmatogenous retinal detachment; Position; Inert gas