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  Indian J Med Microbiol
 

Figure 1: (a) shows the obese patient in a supine position which is the conventional position for retinal surgeries. Visceral fat accumulation leads to increased intra-abdominal pressure which in the supine position, pushes the diaphragm upwards thereby increasing the pleural pressure and cardiac filling pressure. Due to increased pressure on inferior vena cava, venous return from the brain is reduced, leading to increased ICP and IOP. (b) shows the obese patient in RTP (15-20°) with neck extension which leads to lowering of the diaphragm and thereby decreasing the intrapleural pressure and in turn decreased IOP. The neck extension allows the eyeball to be in primary position and the head parallel to the ground, making it easy for the surgeon to maneuver the eyeball for scleral buckling and continue further with vitrectomy and required retinal procedure

Figure 1: (a) shows the obese patient in a supine position which is the conventional position for retinal surgeries. Visceral fat accumulation leads to increased intra-abdominal pressure which in the supine position, pushes the diaphragm upwards thereby increasing the pleural pressure and cardiac filling pressure. Due to increased pressure on inferior vena cava, venous return from the brain is reduced, leading to increased ICP and IOP. (b) shows the obese patient in RTP (15-20°) with neck extension which leads to lowering of the diaphragm and thereby decreasing the intrapleural pressure and in turn decreased IOP. The neck extension allows the eyeball to be in primary position and the head parallel to the ground, making it easy for the surgeon to maneuver the eyeball for scleral buckling and continue further with vitrectomy and required retinal procedure