PRESENTING AUTHOR

This study assessed whether preoperative intravitreal gas injection and face-down positioning for fovea-involving rhegmatogenous retinal detachment before Pars Plana Vitrectomy (PPV) would promote macular reattachment, facilitate surgery, and reduce the need for perfluorocarbon liquid (PFCL) endodrainage. The secondary objective was to evaluate the impact on visual acuity and metamorphopsia.

In this prospective randomized study, thirty participants were randomly assigned to two groups: Group I (n=15) underwent intravitreal gas injection and face-down positioning until PPV, while Group II (n=15) followed standard head posturing before PPV. The study evaluated the influence of preoperative intravitreal gas injection on transitioning to fovea-sparing RRD, PFCL usage for endodrainage, and surgical procedure impact. Postoperative evaluations included Best Corrected Visual Acuity (BCVA) and metamorphopsia using M-Chart at 12 months

: 80% of Group I patients (95% CI: 51.9 to 95.7%) achieved foveal reattachment by surgery, compared to 0% in Group II. Patients with an attached fovea at surgery had lower PFCL usage (41.7%) compared to those with a detached fovea (88.9%) (p=0.013). Surgeons reported that gas injection facilitated surgery in 73.3% of cases. BCVA was similar in both groups at 12 months (p=0.415). Horizontal (p=0.607) and vertical (p=0.679) Metamorphopsia assessments with M-Chart were also similar in both groups.

For patients with fovea-involving RRD, intravitreal gas injection and face-down positioning before PPV significantly increased the likelihood of foveal reattachment before surgery. Notably, this approach correlated with a reduced need for PFCL usage and facilitated surgical ease. This approach did not adversely affect BCVA or metamorphopsia outcomes.