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The Posturing After Retinal Detachment (Post RD) Trial

Completed
Conditions
Retinal Detachment
Registration Number
NCT02748538
Lead Sponsor
Moorfields Eye Hospital NHS Foundation Trust
Brief Summary

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

Detailed 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.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
262
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

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
To assess the proportion of patients in each treatment group with retinal displacement at 26 weeks after surgery26 Weeks

The proportion of patients in each treatment group with retinal displacement at 26 weeks after surgery

Secondary Outcome Measures
NameTimeMethod
To assess the degree of retinal displacement on autofluorescence imaging26 Weeks

Degree of retinal displacement on autofluorescence imaging at 26 weeks

To report the mean (SD) / median (IQR) Visual function score as measured using the Visual Function Questionnaire26 Weeks

To report the mean (SD) / median (IQR) Visual function score as measured using the Visual Function Questionnaire (NEI Visual Function Questionnaire 25) in each treatment group at 26 weeks after surgery.

To assess proportion of patients in each group with retinal displacement at 8 weeksEight weeks

The proportion of patients in each group with retinal displacement at 8 weeks after surgery.

To report the mean (SD)/median (IQR) ETDRS visual acuity score at two different time-pointsEight and 26 weeks

To report the mean (SD)/median (IQR) ETDRS visual acuity score at 8 and 26 weeks after surgery in each treatment group

To report the mean(SD)/median(IQR) Objective distortion score at two different time-pointsEight and 26 weeks

To report the mean(SD)/median(IQR) Objective distortion score at 8 and 26 weeks after surgery in each treatment group - with Objective distortion measured with D Charts

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