Case report: extreme patient positioning for retinal surgery in advanced kyphosis.

Purpose: To describe the atypical intraoperative positioning of a kyphosis patient resulting in successful retinal detachment repair.

Methods: Case report.

Results: A 66-year-old man presented with bilateral vision loss, and pars plana lensectomy and retinal detachment repair were planned for the left eye. Innovative surgical positioning was required for the patient's severe ankylosing spondylitis-related kyphosis, a fixed 90° curvature of his cervical spine. With straps, orthopedic padding and surgical tape, he was securely placed head-down on the operating table. No intraoperative complications occurred, and the retina remained attached at follow-up.

Conclusion: To our knowledge, this is the first report of special positioning for a 90° kyphosis patient requiring retinal surgery. Extreme spinal curvature can hinder suitable horizontal positioning of the eye, but resourceful solutions can make surgical repair possible.