Korean J Ophthalmol.  2007 Jun;21(2):100-105. 10.3341/kjo.2007.21.2.100.

The Results of B-scan Ultrasonography in Different Positions after Vitrectomy and Gas Tamponade

• Park SH
• Lee SJ

• KMID: 1101912
• DOI: http://doi.org/10.3341/kjo.2007.21.2.100

Abstract

PURPOSE: To determine the proper time frame in which to assess retinal attachment status and to evaluate the superior retinal attachment status by performing B-scan ultrasonography in different positions on patients who have undergone pars plana vitrectomy and gas tamoponade. METHODS: In this prospective study, 23 patients (23 eyes) who had undergone pars plana vitrectomy and gas tamponade were investigated between June 2005 and February 2006. SF6 (18%) was injected into the vitreous cavity of 15 eyes, and C3F8 (14%) was injected into the vitreous cavity of 8 eyes. At postoperative day 1, day 3, week 1, week 2, and week 4, B-scan ultrasonography was performed in the supine, sitting, prone, right decubitus, and left decubitus positions. RESULTS: The proper time to evaluate the retinal attachment status was three days post-operatively in 10 eyes (66.7%) with SF6 (18%) injections and two weeks post-operatively in six eyes (75%) that had C3F8 (14%) injections. The superior retinal attachment status can be evaluated from the summation of B-scan ultrasonography results performed in the right decubitus and left ducubitus positions. CONCLUSIONS: The proper time to evaluate the retinal attachment status was related to the degree of the gas absorption when performing B-scan ultrasonography after pars plana vitrectomy and gas tamponade. To evaluate the entire retina, it is useful to perform B-scan ultrasonograhy in the prone, right decubitus and left decubitus positions.

Keyword

B-scan ultrasonography; Gas tamponade; Position; Vitrectomy

MeSH Terms

Adult
Aged
Aged, 80 and over
Air
Female
Follow-Up Studies
Humans
Injections
Male
Middle Aged
Postoperative Period
Prospective Studies
Retina/*ultrasonography
Retinal Diseases/*surgery/ultrasonography
Time Factors
Treatment Outcome
Vitrectomy/*methods
Vitreous Body

Figure

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  Fig. 1 Photographs of B-scan ultrasonography with patients in different positions. (A) Supine position. (B) Sitting position. (C) Prone position. (D) Right decubitus position. (E) Left decubitus position.

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  Fig. 2 On postoperative day 1, the results of B-scan ultrasonography while patients assumed different positions on eyes undergoing vitrectomy and an 18% SF6 gas tamponade. (A) Supine position: can not evaluate the retinal attachment status. (B) Sitting position: can not evaluate the retinal attachment status. (C) Prone position: can not evaluate the retinal attachment status. (D) Right decubitus position: can not evaluate the retinal attachment status. (E) Left decubitus position: can not evaluate the retinal attachment status.

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  Fig. 3 On postoperative day 3, the results of B-scan ultrasonography taken with patients in different positions on the eyes undergoing vitrectomy and an 18% SF6 gas tamponade. (A) Supine position: can not evaluate the retinal attachment status. (B) Sitting position: can evaluate the retinal attachment status greater than 180°. (C) Prone position: can not evaluate the retinal attachment status. (D) Right decubitus position: can evaluate the retinal attachment status greater than 180°. (E) Left decubitus position: can evaluate the retinal attachment status less than 180°.

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  Fig. 4 On postoperative day 7, results of B-scan ultrasonography with the patients in different positions of the eyes undergoing vitrectomy and an 18% SF6 gas tamponade. (A) Supine position: can not evaluate the retinal attachment status. (B) Sitting position: can evaluate the retinal attachment status greater than 180°. (C) Prone position: can not evaluate the retinal attachment status. (D) Right decubitus position: can evaluate the retinal attachment status greater than 180°. (E) Left decubitus position: can evaluate the retinal attachment status greater than 180°.

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  Fig. 5 At postoperative week 1, results of B-scan ultrasonography with patients in different positions on the eyes undergoing vitrectomy and using a 14% C3F8 gas tamponade. (A) Supine position: can not evaluate the retinal attachment status. (B) Sitting position: can not evaluate the retinal attachment status. (C) Prone position: can not evaluate the retinal attachment status. (D) Right decubitus position: can not evaluate the retinal attachment status. (E) Left decubitus position: can not evaluate the retinal attachment status.

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  Fig. 6 At two weeks postoperatively, results of B-scan ultrasonography with patients assuming different positions on the eyes undergoing vitrectomy and using a 14% C3F8 gas tamponade. (A) Supine position: can not evaluate the retinal attachment status. (B) Sitting position: can evaluate the retinal attachment status greater than 180°. (C) Prone position: can not the retinal attachment status. (D) Right decubitus position: can evaluate the retinal attachment status greater than 180°. (E) Left decubitus position: can evaluate the retinal attachment status greater than 180°.

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  Fig. 7 Results of B-scan ultrasonography with the patient in the prone position on the eyes undergoing vitrectomy and using an 18% SF6 gas tamponade. (A) At postoperative day 1, (B) on postoperative day 2, (C) at postoperative day 3, (D) on postoperative day 4, (E) at postoperative day 5, (F) on postoperative day 6, (G) at postoperative day 10, (H) on postoperative day 11: the echogenic image that we thought was the retina proved to be the gas-fluid interface because this echogenic image has moved to the posterior pole from day to day.

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  Fig. 8 The false images on B-scan ultrasonography on the eyes filled with gas. (A) Posterior shadowing (red arrow). (B) Multiple reverberations (blue arrows).

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