The Posturing After Retinal Detachment (Post RD) Trial

A Randomised Controlled Trial to Evaluate the Effect of Face-down Posturing on Retinal Displacement and Distortion Following Retinal Detachment Repair

A randomised controlled trial to evaluate the effect of face-down posturing on retinal displacement and distortion following retinal detachment repair.

During the surgical repair of a retina detachment, a gas bubble is inserted into the eye to keep the retina flat. Following this, it is common to ask patients to adopt a certain head position for a set period of time after their operation. This is known as posturing. It is thought that by adopting a certain head position/posturing, the bubble aids re-attachment of the retina. However, when the retinal detachment involves the macula (central portion of the retina) it has been shown that the retina can shift (or displace) post-operatively, leading to distortion in the patient's vision.

The purpose of this study is to investigate whether adopting different head positions following surgery for macula involving retinal detachments, can reduce retinal displacement and visual distortion. The investigators plan to recruit 368 patients. Patients will be in follow up for a period of six months. The study will be operational at two different hospitals in the United Kingdom.

Inclusion Criteria:

• Fovea-involving rhegmatogenous retinal detachment
• History of central visual loss within the past 14 days
• Patients undergoing vitrectomy and gas surgery, under local anaesthetic
• Able to give informed consent
• 18 years old and over

Exclusion Criteria:

• Previous vitrectomy or cryo-buckle surgery
• Retinal detachment surgery requiring silicone oil tamponade
• Existing ophthalmic condition which limits the patient's visual acuity (BCVA 6/36 or worse)
• Inability to posture post-operatively or commit to follow-up visits