Review Article

Retinal Displacement: Providing New Insights for Retinal Detachment Surgery

Table 1

Study characteristics.

Author, yearStudy typeTotal number of patientsFemale genderFAF imaging modalityQuadrants of RRD affectedMacular statusSurgery typeUse of heavy fluidUse of tamponade agentPostoperative posture

Shiragami [3]Prospective interventional case series4317FC1–2 eyesOn = 12PPV30Gas = 43Sitting several minutes immediately post-op with face-down or appropriate positioning for 7 to 10 days post-op
2–31 eyesOff = 15
3–8 eyes
4–2 eyes

Pandya [6]Retrospective case series50FCN/AOff = 5PPV = 4N/AGas = 5Face-down post-op
SB = 1

Brosh [7]Retrospective consecutive case series23894FC>2 = 91 eyesOn = 71PPV = 1248Gas = 117All but 4 patients in the PPV group had immediate face-down positioning
≤2 = 138 eyesOff = 167PR = 114SO = 4

Schawkat [8]Prospective randomized controlled trial5014FC1–2 eyesOff = 50PPV25Gas = 50Log-roll postoperatively with face-down position vs. lying flat on back for 6 hours
2–23 eyes
3–17 eyes
4–8 eyes

Dell’Omo [10]Prospective observational case series12526FC2–67 eyesOn = 23PPV80Gas = 97Strict prone posture for at least 2 hours in the operating room and during the following 24 hours
3–26 eyesOff = 122SO = 28
4–32 eye

Codenotti [11]Prospective observational case series238cSLO1–6 eyesOn = 13PPV23Gas = 14All patients treated with gas tamponade were immediately positioned face-down
2–10 eyesOff = 10SO = 9
3–3 eyes
4–23 eyes
Sitting position was avoided for the first 24 hours

Cobos [15]Prospective observational case series20N/AcSLO1–5 eyesOn = 12PPVN/AGas = 20Face-down immediately post-op
2–9 eyesOff = 8
3–4 eyes
4–2 eyes

Casswell [13]Prospective randomized controlled trial23968FC + cSLON/AOff = 239PPV3Gas = 239Face-down or support-the-break for 24 h in each group followed by support-the-break positioning for 6 days

Dell’Omo [16]Prospective observational case series208cSLO2.95 (0.75)Off = 20PPV0Gas = 20Strict prone posture for 2 hours post-op

Guber [9]Prospective randomized controlled study5014FC1–2 eyesOff = 50PPV25Gas = 50Group 1: Log-roll (n = 26)
2–23 eyesGroup 2: Lying flat on back for at least 6 hrs (n = 24)
3–17 eyes
4–8 eyes

Lee [5]Prospective observational case series60N/AFCPPV-gas in fovea-involving patients:On = 35PPV = 51PFCL = 16/32 PPV + GAS fovea-involving RRDGas = 49Face-down for >1 hr in almost all patients
1–17 eyesOff = 37§SB = 9SO = 2
2–9 eyes
3/4–5 eyes

Shiragami [12]Prospective randomized controlled trial8633FC1–7 eyesOn = 36PPV63GasGroup 1: Face-down position approximately 10 to 20 minutes after procedure completion
2–49 eyesOff = 50Group 2: Face-down position immediately after surgery
3–26 eyesBoth groups maintained appropriate position for the next 7–10 days
4–4 eyes

Dell’Omo [4]Prospective observational case series336cSLO1–3On = 11PPV15GasN/A
2–15Off = 22
3–9
4–6

Casswell [14]Prospective comparative study70FC + cSLOOff = 70PPV0GasPatients randomized to face-down (32/70) or ‘‘bubble-to-break’’ (38/70) for the first 24 h

Status given for the 27 cases of retinal displacement. †All cases were macula-off, but the fovea was attached in 23 of 125 cases (18.4%) on preoperative OCT examination. Mean (SD). PFCL was used, but number not mentioned. Data only available in supplementary file for patients with fovea-involving detachment that received PPV + Gas. §On: 26 PPV, 7 SB; Off: 34 PPV, 3 SB. cSLO = Confocal scanning laser ophthalmoscope; FC = fundus camera; PPV = pars plana vitrectomy; PR = pneumatic retinopexy; SO = silicone oil.