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Understanding unintentional retinal shift after pars plana vitrectomy (PPV) for rheugmatogenous retinal detachment (RRD) through surgical reverse engineering (SRE) technology. Phase 1 (data input) and phase 2 (data acquisition) results

Session Details

Session Title: FP-16 Vitreoretinal Surgery IV

Session Date/Time: Sunday 14/09/2014 | 11:00-13:00

Paper Time: 11:00

Venue: Boulevard D

First Author: : M.Dogramaci UK

Co Author(s): :    T.H. Williamson   M.K. Bayazit   A. Cunningham   E. Lee     

Abstract Details


We recently demonstrated that symptomatic retinal shifts are common in eyes following vitrectomy surgery for retinal detachments. Because of the alarming symptoms that could be associated with the retinal shifts, it is very difficult to investigate the influencing factors through large scale studies. We used Reverse Surgical Engineering (RSE) technology to assist in studying the influencing factors effectiveness. In this first paper we aimed to determine the important characteristics of the retinal detachment that could influence the pattern and the magnitude of the shift and hence should be incorporated in the computer model.


University Hospital of North Durham (CDDFT, Durham), St. Thomas' Hospital (London) and Imperial College (London)


The baseline data including laterality, retinal breaks, detachment areas, type of the tamponade, immediate and long term post-operative posture were taken from the per-operative notes and the post operative autofluorescence (AF) images of 16 consecutive eyes. The magnitude of the shift, the distance of the sample shift points from the optic disc and diameter of the circular area over which sample points were distributed were also analysed.


Five eyes were excluded from the study because the maximum detectable shifts were less than 100µ. A total of 151 sample points of 11 eyes were analysed. The mean magnitude of shift was 290µ, the mean distance from the centre of the optic disc was 1797µ, and the mean diameter over which sample points were distributed was 9613µ. RRDs involving 3 quadrants and those involving superotemporal quadrants and eyes with immediate upright post operative posturing demonstrated larger shifts (independent t test p<0.05). Eyes operated on within 5 days from the onset of the symptoms and those with only one break were associated with sample points that were closer to the optic disc centre (p = 0.031). The mean distance of the sample points from the optic discs were correlated with the diameter over which the points were distributed ( p= 0.032).


The extend and the location of the retinal detachment and the postoperative posture are factors that could influence the magnitude of the retinal shift. The mean distance of the sample shift points could give an idea on the extend of the area over which the shift is distributed. The chronicity of the retinal detachment could influence the distance of the sample shift points from the centre of the disc and hence the pattern of the distribution of the shift. Therefore these factors should be taken into consideration in constructing a reliable computer models through RSE technology.

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