Face-up vs face-down positioning after rhegmatogenous macula-off retinal detachment surgery: Hypothesis of better recovery

Purpose: To evaluate the differences between two distinct patient postoperative positions following rhegmatogenous macula-off retinal detachment surgery. Methods: In this consecutive clinical study, 26 patients were placed in either the face-up or face-down postoperative position group. Postoperative follow-ups were conducted at 1, 3, and 6 months using type 1 M-CHARTS, best-corrected visual acuity (BCVA), intraocular pressure, and optical coherence tomography imaging to evaluate the functional and anatomical outcomes after surgery. Results: The average vision recovery at 6 months was 0.35159 +/- 0.30945 logarithm of the minimum angle of resolution (logMAR) for the face-up group and 0.81521+/- 0.46662 logMAR for the face-down group. At 6 months, the average horizontal type 1 M-CHARTS for the face-up group was 0.1615 +/- 0.1710 and 0.2846 +/- 0.2828 for the face-down group; and the average vertical type 1 M-CHARTS was 0.1615 +/- 0.1557 for the face-up group and 0.2846 +/- 0.1725 for the face-down group. Conclusion: The face-up position demonstrated significant improvement in both metamorphopsia and BCVA, suggesting that slow reattachment of photoreceptors on the retinal pigment epithelium layer can result in better quality of sight recovery. Further studies with larger sample sizes are warranted to confirm these results. The study adhered to the guidelines of the Declaration of Helsinki.