Face-down positioning (FDP) is recommended after vitrectomy and gas tamponade for rhegmatogenous retinal detachments (RRDs) [1, 2] or for macular hole (MH) surgery [1–33].
Your surgery may not work if you do not recover in the recommended position. This is because lying in the wrong position puts pressure on other parts of your eye. That can lead to other eye problems. You cannot fly in an airplane, go to mountains/high altitudes or scuba dive until the gas bubble is gone.
Certain retinal surgeries require that you keep your head in a face down (parallel to the ground) position during recovery. If this position is not maintained for several weeks after surgery, the surgery will not be successful.
Patients having vitreo-retinal surgery for a macular hole will need to posture face down for 14 days; for other conditions this is only necessary for 5 days.
Don't do things that might cause you to move your head. This includes moving quickly, lifting anything heavy, or doing activities such as cleaning or gardening. If your doctor used an oil or gas bubble to hold the retina in place, keep your head in a certain position for a few days or longer after the surgery.
Face-down positioning (FDP) is recommended after vitrectomy and gas tamponade for rhegmatogenous retinal detachments (RRDs) [1, 2] or for macular hole (MH) surgery [1–33].
Avoid any bending or lifting for 1 week after surgery. After 1 week, you may do light housework and bend over to pick up light objects. Then, gradually resume your regular activities.
You should avoid exercising for at least 2 weeks following your surgery. You may resume normal activities, little by little. After week 1, you may start by walking as much as a mile. You may advance to 2 miles, in the second week and can typically run by week six.
It is recommended to sleep on either side or even your front, but not sleep on your back as that would make the bubble move away from the macular hole.
Watching TV and reading will cause no harm. Your vision will remain blurred / poor for several weeks. Often the vision is distorted after surgery. This will vary depending on the type of operation, e.g. if a gas bubble is inserted into the eye, as the bubble shrinks you might see the edge of the bubble.
Instead of getting a special face-down pillow with a space cut out for your face, you can arrange a large towel into a horseshoe shape to support your head as you sleep. You can also place trays on top of pillows or bean bags to make a useful surface for eating, reading or using a laptop or tablet.
Making your face-down or sideways recovery easier:
Lying down: Lie face down on a pillow, have the recovering side of your face hang off the ledge of the bed. This helps reduce pain and keeps pressure off your operated eye. Anytime: Use special equipment that can make it easier to stay face down or sideways.
If you have a medical oil called 'Silicone oil; in your eye you should avoid lying flat on your back whilst the oil remains in the eye, this is to reduce the risk of the oil seeping into the front part of the eye causing the eye pressure to become unstable.
Activity. For the first 48 hours after the surgery, it is important to rest as much as possible. The best thing to do is to simply relax in bed or in a chair with both eyes closed.
In most cases, it takes around 2 to 4 weeks for the vision to become clear after the vitrectomy. The extent of the clarity of the eyesight after the surgery depends on several factors, including: During vitrectomy, multiple incisions may be taken on the white of the eye called the sclera.
Your eye may be a little sore after the procedure, but you should be able to take over-the-counter pain relievers. You may need to wear an eye patch for a day or so. If you had a gas bubble placed in your eye during your vitrectomy, you will need to follow specific instructions about positioning after the surgery.
In the 7 to 10 days after the operation, the gas bubble slowly starts to shrink. As this happens, the space that was taken up by the gas fills with the natural fluid made by your eye, and your vision should start to improve. It generally takes 6 to 8 weeks for the gas to be absorbed and vision to improve.
Driving after vitrectomy surgery is best avoided for two weeks. It is better to wait for complete visual recovery and take your doctor's permission before resuming driving. Recovery is better with good quality postoperative care.
You can have a shower or bath 24 hours after your surgery. Use a clean washcloth every time and normal tap water to clean secretions from your lashes or the corner of your eye. When you shower or wash your hair, keep your eye closed to keep water and soap out.
Facedown posturing (FDP) is recommended by many vitreoretinal surgeons so that the gas bubble can be apposed to the MH for a sustained time period. This is thought to improve the chance that the hole will close and heal.
As the eye heals and the bubble dissipates, there will be less of a need for you to stay in that specific position. You should avoid sleeping on your back until the bubble has totally dissolved or the oil is removed surgically.
You need to maintain a specific head position for at least three days after surgery. You will need to sleep with head tilted to the side opposite to where the retina break is found at the time of surgery to allow the gas bubble to keep the retina in place around the break area until the retina seals in that area.
The vision through a gas bubble is very poor. A gas-filled eye can often only see movement. As you would expect, a gas bubble dissolves from bottom to top. The eye sees the opposite of what happens inside it, so from the patient's perspective, the bubble appears to dissolve from top to bottom.