Research progress in sensing technology for posture management of patients after complex retinal detachment surgery

Complex retinal detachment (RD), encompassing rhegmatogenous RD, proliferative diabetic retinopathy, and traumatic RD, remains a leading cause of blindness. Pars plana vitrectomy combined with intraocular tamponade (e.g., gas, silicone oil) is the standard surgical approach, where postoperative postural management—often requiring strict face-down or specific head positioning for 16 hours daily over weeks—is critical to ensure effective tamponade of retinal breaks and promote reattachment. However, conventional posture management relies heavily on manual supervision and patient self-reporting, which are labor-intensive, discontinuous, and suffer from poor adherence, particularly during nighttime. In recent years, digital health technologies, especially sensor-based monitoring systems, have emerged as promising solutions to address these limitations. This review systematically synthesizes current evidence on the application of various sensing technologies for postoperative posture monitoring in patients undergoing complex RD surgery, identifying original studies, clinical trials, and technical reports related to pressure, infrared, inertial, angle, and temperature sensors used for head/body position monitoring. Five main sensor modalities were identified: (1) pressure sensor arrays embedded in pillows or supports detect contact pressure distribution changes and trigger alarms when the head deviates from the required position; these enable automated real-time monitoring but require individual calibration and have durability concerns; (2) infrared-based systems non-invasively sense head presence relative to a positioning frame and automatically record compliance time; they offer contactless measurement but can be affected by ambient light and patient movement; (3) posture sensors, typically micro-electromechanical systems (MEMS) inertial measurement units (accelerometers, gyroscopes) integrated into headbands or ear-hooked devices, continuously track three-dimensional head orientation and provide vibratory or auditory feedback upon deviation; (4) angle sensors precisely quantify head tilt relative to gravity (e.g., horizontal or vertical baselines) using accelerometers; they provide objective angular data and allow individual baseline setting, though they focus on single-axis measurements; (5) temperature sensors are used adjunctively with other sensors to confirm device-wear status by detecting skin contact, thereby enhancing monitoring reliability. Beyond accuracy and real-time feedback, sensor-based systems generate continuous quantitative data that enable healthcare providers to remotely track patient compliance, identify patterns of non-adherence, and tailor interventions accordingly. For instance, thermal map analyses revealed that patients tend to deviate “upward and toward the operated eye,” informing targeted corrections. Despite these advantages, several challenges hinder widespread clinical adoption: measurement inaccuracies, limited wearability and comfort (bulky designs, skin irritation, sleep disruption), insufficient battery life (smartphone-based apps consuming 18%–22% battery per hour), high device costs, and lack of reimbursement, which particularly affect elderly and low-resource populations. Moreover, most studies are small-scale with short follow-up, and evidence linking improved compliance to better anatomical and visual outcomes remains limited. Future directions should focus on multi-sensor fusion to enhance accuracy and personalization; developing low-cost, ergonomic, and user-friendly devices; conducting large-scale, multicenter randomized controlled trials to establish clinical effectiveness and cost-effectiveness; and integrating these systems into telemedicine platforms for seamless home monitoring. In conclusion, sensor-based posture management holds substantial potential to revolutionize postoperative care for complex RD patients by improving adherence, reducing complications, and enabling data-driven precision nursing. However, overcoming current technical, economic, and evidence gaps is essential to translate these innovations into routine clinical practice and ensure equitable access for all patients.