Peking University People's Hospital Liu Jia Team Unveils Ophthalmic Prone Position Monitor to Transform Postoperative Care

The eyes are the human body’s most critical visual organs, featuring intricate, complex, and fragile structures. Ophthalmic diseases encompass a wide range of conditions that affect individuals across the entire lifespan, from infants just beginning to speak to the elderly in their advanced years.

According to data from both domestic and international sources,Approximately 1-2 per 10,000 peopleRetinal detachment occurs. It can occur in individuals of any age group.

Retinal detachment refers to the separation of the neurosensory retina from the retinal pigment epithelium. The detached portion of the retina is unable to perceive light stimuli. If not treated promptly, it can lead to macular detachment, severely impairing vision and ultimately resulting in complete vision loss.

CurrentlyVitrectomyAs the primary treatment for retinal detachment, vitrectomy can be combined with silicone oil or gas tamponade to maximize the restoration of visual function. Postoperatively, patients are typically required to maintain a prone position for an extended period to achieve adequate retinal tamponade.

To ensure the success of vitrectomy with intraocular tamponade, in addition to the surgeon’s exceptional surgical skills, postoperative care is also critical. The most important aspect of this care isPostoperative Prone Position Anglecontrol.

Postoperatively, patients are required to maintain a prone position for an extended period to facilitate retinal repair. However, the so-called prone position does not simply mean lying flat on one’s stomach; it requires specific angular positioning. The angle and duration of the prone position vary depending on the patient’s condition, individual physical status, and the type of intraocular tamponade agent used.

If the angle and duration of prone positioning are not properly managed, the detached retina may fail to reattach in a timely manner. Furthermore, intraocular tamponade agents such as gas or silicone oil will remain in prolonged contact with the lens, disrupting its nutrition and metabolism, which significantly increases the risk of complications including cataracts and corneal endothelial damage.

However, currently, the medical devices available on the market for prone position therapy are limited to U-shaped soft pillows and prone positioning tables. These devices can only improve patient comfort during prone positioning and have little effect on controlling the angle. Therefore, control of the prone position angle relies solely on nurses providing guidance and correction during patient rounds.

However, nursing supervision of patients in the prone position also involves time intervals. After patients change their body position, most are unable to self-assess the prone angle, thereby failing to ensure the maintenance of the prone position.

Liu Jia, Head Nurse of the Department of Ophthalmology, Peking University People's HospitalShe and her team identified the aforementioned issues in their work. After extensive research, they found that the continuous management of postoperative prone positioning angles has become a critical barrier in ophthalmic nursing that urgently needs to be overcome. Their ultimate goal is to leverage modern technologies and innovative concepts to address these nursing deficiencies, thereby achieving satisfaction among healthcare providers, nurses, and patients alike.

Through prolonged clinical reflection and continuous observation in daily life, Liu Jia’s team gradually conceived the idea of an ophthalmic prone-position monitoring device: it monitors patients in real time and records changes in their body position; family members can remotely observe the patient’s positioning via a wireless network, enabling “cloud companionship”...

With this in mind, Liu Jia’s team spent approximately five years conducting multiple experiments and iterative improvements to developOphthalmic Prone Position DetectorSo, how exactly does the ophthalmic prone-position monitoring device achieve “precision nursing”? What difficulties did Liu Jia’s team encounter during the research and development process? Affected by2022 2nd Biomedical High-Value Patent Project Selection ActivityInvitation,VCBeat Orange BureauwithLiu Jia's TeamA deep conversation was conducted.

The most critical step in scientific research is inspiration, which never emerges from a sudden whim. Just as the apple falling on Newton sparked the insight into universal gravitation, the “apple” that struck Liu Jia can be traced back five years.

At that time, an elderly veteran underwent pars plana vitrectomy with intraocular tamponade at Peking University People's Hospital, where Liu Jia was based.

Perhaps the disciplined rhythm of military life forged the elderly man’s meticulous character, evident even in his insistence on folding his hospital blanket into a perfect “tofu block.” Accordingly, he adhered strictly to medical advice, never cutting corners when it came to the precise angle and duration required for daily prone positioning. However, deviations in head alignment occasionally occurred during standing or sitting positions, which nurses would correct during their routine rounds.

During a routine round, Nurse Mei Ningjing noticed that the elderly patient’s head was not lowered sufficiently while walking and reminded him, “Sir, your posture is incorrect. Please tuck your chin toward your chest.”

The elderly man retorted defiantly, “Nurse, I’m already in the Trendelenburg position. If you claim my technique is substandard, then show me the data!”

After hearing this, Mei Ningjing was momentarily at a loss for words, as the determination of the prone position angle for patients largely relies on nurses’ clinical experience and judgment; indeed, she could not provide the “data” referenced by the elderly patient.

Upon returning to the nurses’ station, she discussed the matter with Liu Jia, the head nurse. After listening, Liu Jia remarked, “This is indeed an issue. Currently, we can only rely on experience to judge whether the patient’s angle is correct. It would be ideal to have an objective indicator for reference.”

The elderly patient was discharged smoothly, but this incident planted a seed in the hearts of Liu Jia and Mei Ningjing.

During a night shift, the remote monitor emitted an urgent alarm. Mei Ningjing promptly approached to check and found that the patient’s monitoring waveform, previously stable and regular, had suddenly become erratic. Drawing on her 12 years of clinical experience, she suspected that the monitor’s electrode pads had become loose; subsequent inspection confirmed this.

The next day, while reviewing the patient’s overnight condition records, Liu Jia came across the monitoring logs from that period. After inquiring about the reasons behind them, she fell into contemplation as she observed Ning Jing’s exhausted appearance:If patients in the prone position could also have such a device that provides timely alarms for correction, and continuously monitors and records their positioning, it would not only meet clinical needs but also reduce nurses’ workload—truly a win-win solution.

Acting swiftly on the idea, Liu Jia initiated successive rounds of brainstorming within the team. During this process, they designed a prone-positioning support frame inspired by orthopedic walkers. However, as this device failed to accommodate all patients and required improvements in height adjustability, patient monitoring, portability, and innovativeness, the concept was ultimately shelved.

Finally, through a series of efforts including literature review, consultation with experts, and summarization of clinical experience, Liu Jia’s team successfully developedOphthalmic Prone Position Detector。

Currently, all widely used clinical devices feature simple structures and ease of operation. The ophthalmic prone-position monitoring device developed by Liu Jia’s team integrates precision, convenience, efficiency, and practicality.

From the appearance, the ophthalmic prone position detector only consists of aComposed of a fixed ear hook, an angle sensor, and a display screen., extremely simple. The operation is also exceptionally convenient; simply secure the ear hook behind the patient's ear to enable monitoring of the prone position angle.

The “simplicity” of the ophthalmic prone-position examination device, in addition to its ease of operation, enhances its feasibility for market entry.

Due to its simple structure, it does not require “high-end, precision, and advanced” materials for manufacturing, resulting in significantly lower costs compared to other medical devices. Furthermore, the concept of the ophthalmic prone-position examination device is highly mature. According to research conducted by Liu Jia’s team, production lines for most of the required components are already available on the market. The only remaining challenges lie in assembly and the mutual compatibility of the components.

Therefore, the cost required to achieve mass production of ophthalmic prone-position monitoring devices is relatively low, indicating high operational feasibility.

However, the “simplicity” of the ophthalmic prone-position monitor is only superficial; when it comes to the medical problems it can address, it is far from “simple.”

Overall, its effects manifest differently across different subjects:

For Patients, capable of continuously monitoring postural angles and promptly issuing alerts for deviations. Patients can continue to wear the device even after discharge, facilitating continuous care and ensuring uninterrupted post-discharge rehabilitation. Its compact and refined design enhances wearing comfort, thereby improving patients' initiative and adherence to treatment.

For Physicians, information obtained through network transmission can be used to collect rehabilitation data of relevant patients and provide reasonable analysis and interpretation of further disease outcomes.

For Nurses, which can significantly reduce nursing labor hours and improve the effectiveness of precision nursing.

For Family Members, enabling easy monitoring of patients' daily rehabilitation progress without the need for constant, round-the-clock in-home caregiving, thereby alleviating the burden on families.

So, how exactly is this “small device” made?

First,Ophthalmic prone position monitoring device enables precise control of patient positioning.

The lead surgeon determines the clinical 0° based on the location of the patient’s retinal tear; however, this clinical 0° differs from the conventional 0°. In simple terms, the postoperative prone position is not always parallel to the ground. Often, it involves a more pronounced head-down tilt than the standard face-down position, resulting in a “headstand-like” posture.

Therefore, there is considerable subjectivity in the assessment of patient positioning by both patients and nurses, with a high likelihood of deviation in cases of insufficient experience. Additionally, due to variations in filling materials and individual physiological conditions, some patients are required to maintain the prone position for one to two months. After discharge, in the absence of nursing supervision, it becomes challenging for patients to independently determine whether the positioning angle is correct.

The ophthalmic prone position monitor can address this issue. Postoperatively, clinicians can input the prescribed patient positioning parameters into the device. If the patient’s angle deviates beyond a predefined threshold, the angle sensor on the ophthalmic prone position monitor will immediately detect the deviation and trigger an automatic alarm to prompt the patient to correct their posture promptly. This ensures accurate patient positioning and improves surgical success rates.

Additionally, the ophthalmic prone position monitor will alsoAutomatically record changes in patient positioning angles and duration of maintenance....and transmitted to the healthcare providers’ system, where it is stored as medical data. Healthcare professionals can review the stored curves to understand and evaluate the patient’s positioning during this phase, assess patient compliance based on the data, and accurately formulate the treatment plan for the next stage, thereby achieving optimal rehabilitation outcomes.

Meanwhile,Family members can also monitor the patient’s home rehabilitation progress via the app., thereby alleviating the family burden of patients being “tied down” by caregivers, while enabling them to master correct rehabilitation positioning without frequent hospital visits, thus achieving “cloud companionship.”

Furthermore, the ophthalmic prone-position monitoring device can collect extensive clinical data for physicians, providing them with more authentic and valid clinical evidence, thereby enhancing China’s capacity to treat fundus diseases and supporting advancements in ophthalmic medical research.

Next, Liu Jia’s team aims to integrate the ophthalmic prone-position examination device withFar-infrared technology, VR technologycombined to enhance the subjective accuracy and engagement of rehabilitation therapy, achieving medical objectives such as restricting patient eye movement, and stimulating patients' initiative in postoperative recovery treatment.

Liu Jia stated, “It is inevitable that patients will experience physical discomfort during treatment. Only by making the treatment process more humane and compassionate can we alleviate their psychological distress. As healthcare professionals, our greatest aspiration is to ensure patient satisfaction.”

Retinal detachment and macular holes have always been complex fundus diseases that severely affect patients' vision, causing significant difficulties in their daily lives and work. These two conditions are not rare in China. Vitrectomy with internal tamponade is currently the primary treatment for these complex eye diseases.

Therefore, the ophthalmic prone position detector developed by Liu Jia’s team is applicable toThe market maturity is very high....with strong market demand, yet she told VCBeat’s Achievement Bureau:“We are still on the path to finding collaboration.”

"Great talents are common, but those who can recognize them are rare. No matter how excellent a product is, it requires professional partners to facilitate its subsequent commercialization and implementation, ultimately benefiting patients."

Although the hospital has provided strong support by offering platforms for demonstration and promotion, they have been striving to find partners who are not only capable but also appreciate the significance of this technology. However, due to the limited number of partners accessible through the hospital and the demanding nature of clinical work, they have yet to identify a suitable partner.

In fact, Liu Jia’s team has a very straightforward attitude toward the commercialization of research outcomes—Both independent commercialization and technology transfer are acceptable; the ultimate goal is to enable the early clinical adoption of the ophthalmic prone-position monitoring device, thereby benefiting more patients.

Currently, in addition to financial and production line support, they are more in need ofMedical Informaticspartners in this area. Because, for the further upgrade and innovation of the ophthalmic prone position detector, the most critical need is chip development, which is a relatively weak point in Liu Jia’s team.

In recent years, the pandemic has significantly increased the work pressure on healthcare professionals. Nevertheless, Liu Jia’s team has remained committed to advancing the clinical translation of the ophthalmic prone-position monitoring device. As most team members are nurses with extensive clinical experience, they possess a deep understanding of the challenges patients face in rehabilitation and nursing care. For them, patient satisfaction represents the highest form of recognition for their work.

Liu Jia told VCBeat’s Chengguo Bureau, “We have always been eager to see the ophthalmic prone-position monitoring device adopted in clinical practice as early as possible, enabling our patient care to transcend humanistic approaches and embrace technological innovation, thereby bridging the ‘last 20 meters’ between precision nursing and patients. Throughout this journey, we have made considerable efforts, acquired knowledge in many unfamiliar fields, and sacrificed significant personal time and energy. We have even questioned ourselves whether such perseverance truly holds meaning and whether it will ultimately bring greater benefits to more patients.”But now, we no longer question it; enabling patients to receive comfortable care as early as possible is our greatest aspiration as healthcare professionals.”