ReviewInternational journal of retina and vitreous2026
Impact of postoperative positioning on surgical and visual outcomes after pars plana vitrectomy for rhegmatogenous retinal detachment: a systematic review and meta-analysis.
Review in International journal of retina and vitreous, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
introductionRhegmatogenous retinal detachment (RRD) is a serious ophthalmic pathology managed with pars plana vitrectomy (PPV) with gas tamponade. Even though prone position after surgery is widely used, it has been questioned because of high patient discomfort and contradictory evidence concerning its effects on functional outcomes.
objectiveTo assess the effect of various positioning options post-surgery on the rate of retinal reattachment and visual outcome after PPV for RRD.
methodsA systematic review and meta-analysis were carried out in accordance with the PRISMA statement. Searches for related papers in PubMed, Scopus, and Web of Science databases were made up to April 2026. Articles describing postoperative positioning after PPV for RRD were considered for inclusion. Primary outcomes were retinal reattachment rate and changes in best corrected visual acuity (BCVA).
resultsTen studies with 1262 eyes were included. Pooled analysis showed no statistically significant difference in retinal reattachment rate between prone/face-down positioning and support-the-break/adjustable positioning (RR = 0.96, 95% CI 0.84 to 1.11, p = 0.231), with moderate heterogeneity. The evidence for reattachment rate outcome was of low certainty. Two studies with 90 eyes showed a very small borderline difference in logMAR BCVA change in favour of prone positioning versus supine positioning (MD = -0.07, 95% CI -0.14 to 0.00, p = 0.049). However, the certainty of evidence for this comparison was very low. The clinical relevance of this small difference is uncertain. Descriptive single-arm analyses demonstrated postoperative improvement in BCVA for both the prone and supine positioning arms, nonetheless, there was significant heterogeneity in these analyses.
conclusionIn the pooled analysis, there was no statistically significant difference in the rate of retinal reattachment between prone positioning and support-the-break positioning after PPV for RRD, and the certainty of evidence for this outcome was low. For BCVA, the pooled analysis showed a small borderline difference in logMAR BCVA in favour of prone positioning versus supine positioning. However, the certainty of evidence for this comparison was very low and the clinical importance of this finding is unclear. Thus, the current evidence does not allow a strong conclusion of clinically meaningful functional superiority of prone positioning. Postoperative positioning should be determined by the location of the retinal break, the tamponade agent, surgical factors, patient tolerance, and the judgment of the clinician. CLINICAL TRIAL NUMBER: Not applicable.
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