title: Short-time prone posturing is well-tolerated and reduces the rate of unintentional retinal displacement in elderly patients operated on for retinal detachment.
abstract: OBJECTIVE
  To evaluate the feasibility, efficacy and safety of strict prone posturing taken for 2 hours after operation in preventing the occurrence of unintentional retinal displacement in elderly patients operated on for retinal detachment (RD).
  
  
  METHODS
  Twenty patients aged 60 or more with diagnosis of macula-off RD were asked to keep a strict face-down posturing for 2 hours after vitrectomy and 20% sulfur hexafluoride tamponade. IOP was measured immediately before and after surgery and after the 2-hour posturing. A questionnaire was administered to each patient to evaluate the rate of discomfort experienced because of the face-down posturing. Unintentional displacement of the retina was assessed by evaluating the presence of retinal vessel printings on fundus autofluorescence images taken 4 weeks after operation.
  
  
  RESULTS
  The 2-hour posturing was generally well-tolerated. A mild neck pain was the most common reported symptom. Only a few patients experienced moderate breath shortness while posturing and none had to break the posturing because of respiratory problems. Intraocular pressure (IOP) measured before operation (11.7 ± 2.6 mmHg) was significantly different from IOP recorded at the end of surgery (18.9 ± 4.9 mmHg) and from IOP measured 2 hours after surgery (16.8 ± 4.7 mmHg, P<0.05, Friedman test). IOPs measured immediately and 2 hours after surgery did not differ significantly. Fundus autofluorescence imaging showed RVPs in 7 eyes.
  
  
  CONCLUSIONS
  This study shows that a 2-hour face-down posturing is effective in reducing the rate of retinal displacement in patients operated on for rhegmatogenous retinal detachment using vitrectomy and SF6 20%. A 2-hour face-down posturing is feasible for elderly patients and does not appear to cause unwanted, post-operative IOP raises.
authors.forename: Roberto
authors.initials: R
authors.lastname: dell'Omo
authors.forename: Francesco
authors.initials: F
authors.lastname: Semeraro
authors.forename: Germano
authors.initials: G
authors.lastname: Guerra
authors.forename: Marco
authors.initials: M
authors.lastname: Verolino
authors.forename: Mariapia
authors.initials: M
authors.lastname: Cinelli
authors.forename: Stefania
authors.initials: S
authors.lastname: Montagnani
authors.forename: Ciro
authors.initials: C
authors.lastname: Costagliola
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000473:pathology*; D016684:Prone Position; D011446:Prospective Studies; D012163:Retinal Detachment / Q000601:surgery*; D012164:Retinal Diseases / Q000517:prevention & control*; D013997:Time Factors; D014821:Vitrectomy