To evaluate patient compliance for prone positioning after surgery using an innovative device .

Author: Ashish Ahuja (India)

Co-authors:

Purpose

To investigate the use of an innovative device (post vitrectomy recovery system) that has a sensor embedded in the headrest ( horse shoe shaped ) with data-logging function in real time to measure compliance of patients to maintain face down positioning (FDP) after vitrectomy surgery .

Setting/Venue

All patients were enrolled after taking an informed consent for the Vitrectomy surgeries requiring face down positioning in the post operative period . All surgeries were performed by a single surgeon . Surgeries done included macular hole , retinal detachment with inferior retinal breaks and open globe injury with IOFB with retinal detachment .

Methods

Patients were asked to use the cushion to maintain face down positioning as soon as the patient reached home after surgery . The sensor relayed the data via an inbuilt SIM card to our server online which helped to track the data in real time regarding the duration for which the prone position was maintained. Within our pilot study, we investigated the use of a (patent pending ) pressure sensor embedded in the headrest of a supportive furniture with data-logging function to measure the compliance of patients after vitrectomy surgery . The sensor was build to relay the data as soon as it is pressed and so the duration for which the sensor is pressed could be tracked . 13 patients were evaluated but 2 patients had to be excluded as they could not maintain FDP in the post op period due to chest pain and Breathlessness during FDP . 11 patients were evaluated in this pilot project , out of which 6 were male and 5 were females with the age group ranging from 28 - 71 years . The duration of prone position maintained , varied from 4 days to 12 days .

Results

The average duration of face down positioning was 5.5 hours in the first 24 hours . Compliance for FDP reduced over the next few days . The adherence was significantly better after MH surgery than after RRD surgery. Adherence was higher in female than in male patients Out of 11 patients , 5 underwent macular hole surgeries which showed a successful closure of MH in all cases . Out of 5 patients of retinal detachment , 4 cases achieved anatomical success and one case required re surgery in the postoperative period . Patients were given a questionnaire which suggested the device did help them in improving compliance to maintain FDP in the post op period .

Conlusions

To summarize, we observed a good acceptance of our device to measure compliance of patients after vitrectomy surgery to maintain FDP . Further studies are needed to analyse how much time of FDP is sufficient to improve the surgical success in the indicated cases .

Financial Disclosure

YES i do have financial relation with the company that i have developed the device along with . company name is Vision cure private LTD. and i have an equity stake in this company that will providing this device in the future . my role has been of advisory , in the development of this innovative device .