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Dimopoulos, Spyridon, MD*; Vivell, Julian*; Ziemssen, Focke, MD*; Bende, Thomas, PhD; Bartz-Schmidt, Karl Ulrich, MD*; Leitritz, Martin Alexander, MD

doi: 10.1097/IAE.0000000000002006
Original Study

Purpose: To investigate the use of a head-fixed feedback sensor to improve good positioning times after macular hole or retinal detachment surgery. The instructional methods, macular hole closure rates, and questionnaire responses were also evaluated.

Methods: After randomization, sensor devices with different feedback types (none/acoustic/vibration) were fixed on the patients' heads. Two positioning recommendations (verbal/illustrated) were used. The posturing data were logged every 500 ms for 24 hours.

Results: Forty-eight data sets (24 per group) were evaluated. Using sensory feedback, the median time for face-down positioning after macular hole surgery (Group 1) was significantly boosted from 463 minutes (range: 61–1,168) to 1,257 minutes (range: 1,024–1,327). The side positioning time after retinal detachment surgery (Group 2) increased from a median of 1,032 minutes (range: 520–1,165) to 1,284 minutes (range: 1,231–1,437). The night-time alarm records were reduced; however, the instructional methods exhibited no noteworthy effects. The questionnaires indicated positive acceptance of the sensors.

Conclusion: Sensory feedback may help in cases where face-down or side positioning is recommended. These constant reminders were superior to verbal or written reminders; however, further studies are required to assess the clinical impact of sensory feedback on patient positioning.

The use of a head-fixed position sensor, providing patients with acoustic or vibrating feedback, significantly increases the attainment of desired positioning and can support further studies to evaluate the impact of positioning after ocular surgery.

*Centre for Ophthalmology, University Eye Hospital, Tübingen, Germany; and

Section for Experimental Eye Surgery and Refractive Surgery, Centre for Ophthalmology, University Eye Hospital, Tübingen, Germany.

Reprint requests: Martin Alexander Leitritz, MD, Section for Experimental Eye Surgery and Refractive Surgery, Centre for Ophthalmology, University Eye Hospital, Eberhard Karls University of Tübingen, Elfriede-Aulhorn-Straβe 7, 72076 Tübingen, Germany; e-mail:

None of the authors has any financial/conflicting interests to disclose.

© 2019 by Ophthalmic Communications Society, Inc.