The Posturing After Retinal Detachment (Post RD) Trial

Moorfields Eye Hospital NHS Foundation Trust

Status: Completed

Conditions: Retinal Detachment

Study type: Observational

Funder types: Other

Identifiers

NCT02748538

CHAD1032

Details and patient eligibility

About

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

Full description

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.

Enrollment: 262 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

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

Trial design

262 participants in 2 patient groups

Face Down

Description:

To posture in the face down position for the first 24 hours following surgery.

Position to Support the Break

Description:

The head is positioned so that the retinal breaks (which caused the retinal detachment) are positioned at the highest point of the eye and well supported by the intra-ocular gas bubble left within the eye at the completion of surgery.