Adherence to the face-down positioning after vitrectomy and gas tamponade: a time series analysis

Suzuki, Kazuto; Shimada, Yoshiaki; Seno, Yui; Mizuguchi, Tadashi; Tanikawa, Atsuhiro; Horiguchi, Masayuki

doi:10.1186/s13104-018-3257-1

Cited by 17 publications

(12 citation statements)

References 35 publications

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“…However, patient adherence could be retrospectively obtained from nursing records of patients along with their surgical outcomes. As shown in our previous studies [26, 38, 40], adherence to FDP considerably varies among patients and is particularly higher in females than in males, although the differences between the sexes were not significant. Interestingly, patient age has little effect on the adherence rate [26, 38, 40].…”

Section: Discussionmentioning

confidence: 56%

“…Although the such devices continuously record the position of the head for 24 h and its real-time feedback improves patient adherence [34, 39], it must be mounted on the patient’s head at all times, which can possibly increase the strain on patients. In this study, observational patient adherence assessment was based on a sampling frequency of only four [26, 38, 40] or seven times a day. However, patient adherence could be retrospectively obtained from nursing records of patients along with their surgical outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Although the nurses continued these evaluations until the gas disappeared or the patient was discharged, we included data obtained only from the first 3 postoperative days. While the 3-day assessment was also used in our previous studies, the observations in those studies were only four times a day [26, 38, 40]; this frequency was increased to 7 times a day in current study. Therefore, a total of 21 observations were recorded for each patient.…”

Section: Methodsmentioning

confidence: 99%

“…Face-down positioning (FDP) is the standard recovery posture following vitrectomy with gas tamponade for treating macular hole (MH) closure [1–40]. However, FDP is inconvenient and not easily tolerated by many patients, and thus, the duration of continuing FDP has been debated for years [2–8, 10–25, 29, 32–35].…”

Section: Introductionmentioning

confidence: 99%

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Adherence to face-down and non-supine positioning after macular hole surgery

et al. 2018

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BackgroundThis study aimed to investigate patient adherence to face-down positioning (FDP) and non-supine positioning (NSP) following vitrectomy with gas tamponade for treating macular holes (MHs).MethodsNursing records of 92 patients who underwent vitrectomy with gas tamponade for small-diameter (diameter < 400 μm) MHs during April 2016–June 2017 were examined. Forty-seven and 45 patients were instructed to maintain FDP and NSP (FDP and NSP groups), respectively. Patient adherence was evaluated seven times a day for 3 days, and the adherence rate was calculated.ResultsThe mean adherence rate was significantly higher in the NSP group (99.3% ± 2.7%) than in the FDP group (93.7% ± 13.3%; P < 0.001, Mann–Whitney U test). Forty-one patients (91.1%) in the NSP group had an adherence rate of 100%, which was significantly higher than that in the 24 patients in the FDP group (51.1%; P < 0.001, chi-squared test). No statistically significant difference was observed between the patients in the two groups regarding sex, age, MH diameter, and pre- and postoperative visual acuities. MH closure was achieved in all patients.ConclusionsAlmost half of the patients in the FDP group did not obtain 100% adherence rate, suggesting that patient adherence was largely compromised. Patient adherence was better in the NSP group as patient compliance to NSP was better, however, 8.9% of patients were found in face-up positioning at least once. Incompleteness of patient adherence was common, although to differing degrees.

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Adherence to face-down and non-supine positioning after macular hole surgery

et al. 2018

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“…Shorter durations of restricted positioning regimens ameliorate some of the discomfort patients experience and consequently are associated with improved adherence to the positioning protocol. 26 The initial reattachment rate associated with adjustable positioning regimens may be comparable to that observed in cohorts of prone-positioned patients. 20,25 Adjustable positioning that is modified based on spatial characteristics of the retinal break is thought to promote better tamponade-break contact than does rigid prone positioning.…”

Section: Discussionmentioning

confidence: 85%

Outcomes of Rhegmatogenous Retinal Detachment Repair With Nonrestricted Postoperative Positioning

Soliman

Nithianandan

McDonald

et al. 2019

Journal of VitreoRetinal Diseases

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Purpose: To investigate the anatomical success rate associated with rhegmatogenous retinal detachment (RRD) repair without postoperative head positioning. Methods: Data on 182 individuals undergoing pars plana vitrectomy (PPV) with or without phacoemulsification or scleral buckle for primary RRD with intraocular tamponade were retrospectively reviewed. The primary outcome was the initial anatomical success rate. Secondary outcome measures were the change in best-corrected visual acuity and the final reattachment rate. Results: A total of 122 eyes from 122 patients who underwent RRD repair without postoperative positioning were included in this study. PPV alone was performed in 39% of cases, whereas the remaining patients had PPV combined with phacoemulsification (35%), with scleral buckle (19%), or both (7%). Inferior breaks between the 4 o’clock and 8 o’clock positions were present in 47% of cases. Primary and final anatomical success was achieved in 86% and 98% of cases, respectively. The most common cause for redetachment was proliferative vitreoretinopathy. Age and combined inferior retinal and superior breaks were predictive of recurrence in the logistic regression model. The mean baseline best-corrected visual acuity improved from 1.2 (Snellen equivalent, 20/320) to 0.76 (Snellen, 20/125) logarithm of the minimum angle of resolution after retinal reattachment ( P < .001). Conclusions: PPV combined with or without phacoemulsification or scleral buckle for primary RRD in pseudophakic eyes or those rendered pseudophakic is associated with good anatomical outcomes without restricted postoperative head positioning. Retinal detachment in eyes with combined retinal inferior and superior breaks may have a lower success rate, and whether this is due to lack of postoperative positioning needs further evaluation in prospective, controlled studies.

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