Results of vitreous surgery with 20% C3F8/air mixture for macular holes larger than 800 μm
DOI:
https://doi.org/10.31288/oftalmolzh201923338Keywords:
macular hole larger than 800 μm, vitreous surgery, tamponade with the 20% C3F8/air mixtureAbstract
Background: Vitreous surgery for large macular holes is still a challenge to the ophthalmologist.
Purpose: To assess the efficacy of the 20% C3F8/air mixture in the vitrectomy surgery for macular holes > 800 μm in diameter.
Materials and Methods: Twenty-two patients with macular hole of diameter ranging from 800 to 1,470 μm underwent vitrectomy with internal limiting membrane (ILM) peeling and tamponade with the 20% C3F8/air mixture.
Results: At 2 months after gas resorption, the macular hole was completely closed in 20 of the 22 eyes (90.9%). In addition, diameter of the hole dropped from 1,100 μm to 150 μm in one eye, and the hole did not close in another eye. Visual acuity improved significantly (χ2 = 13.15, p = 0.001) to 0.08-0.35. In 3 eyes, 12 eyes and 7 eyes, visual acuity improved to 0.05 – 0.08, 0.09 – 0.12, and 0.14 – 0.35, respectively.
Conclusion: The study demonstrated a high efficacy of the 20% C3F8/air mixture in the treatment of macular holes > 800 μm in diameter.
References
1.Kang HK, Chang AA, Beaumont PE. The macular hole: report of an Australian surgical series and meta-analysis of the literature. Clin Exp Ophthalmol. 2000 Aug;28(4):298-308. https://doi.org/10.1046/j.1442-9071.2000.00329.x
2.Mc Cannel CA, Ensminger JL, Diehl NN, et al. Population-based incidence of macular holes. Ophthalmology. 2009 Jul;116(7):1366-9.https://doi.org/10.1016/j.ophtha.2009.01.052
3.Gass JD. Reappraisal of biomicroscopic classification of stages of development of a macular hole. Am J Ophthalmol. 1995 Jun;119(6):752-9.https://doi.org/10.1016/S0002-9394(14)72781-3
4.Kelly NE, Wendel RT. Vitreous surgery for idiopathic macular holes. Results of a pilot study. Arch Ophthalmol. 1991 May;109(5):654-9.https://doi.org/10.1001/archopht.1991.01080050068031
5.Gander IC, Senn P, Lüthi M, Schipper I. [Prognostic factors and results after surgical treatment of idiopathic macular holes, stage 2 and 3]. Klin Monbl Augenheilkd. 2000 May;216(5):272-7. German.https://doi.org/10.1055/s-2000-10559
6.Freeman WR, Azen SP, Kim JW, et al. Vitrectomy for the treatment of full-thickness stage 3 or 4 macular holes. Results of a multicentered randomized clinical trial. The Vitrectomy for Treatment of Macular Hole Study Group. Arch Ophthalmol. 1997 Jan;115(1):11-21.https://doi.org/10.1001/archopht.1997.01100150013002
7.Tadayoni R, Gaudric A, Haouchine B, Massin P. Relationship between macular hole size and the potential benefit of internal limiting membrane peeling. Br J Ophthalmol. 2006 Oct; 90(10): 1239-41.https://doi.org/10.1136/bjo.2006.091777
8.Jackson TL, Donachie PH, Sparrow JM, Johnston RL. United Kingdom National Ophthalmology Database study of vitreoretinal surgery: report 2, macular hole. Ophthalmology. 2013 Mar;120(3):629-34.https://doi.org/10.1016/j.ophtha.2012.09.003
9.La Cour M, Friis J. Macular holes: classification, epidemiology, natural history and treatment. Acta Ophthalmol Scand. 2002 Dec;80(6):579-87.https://doi.org/10.1034/j.1600-0420.2002.800605.x
10.Michalewska Z, Michalewski J, Adelman RA, Nawrocki J. Inverted internal limiting membrane flap technique for large macular holes. Ophthalmology. 2010 Oct;117(10):2018-25.https://doi.org/10.1016/j.ophtha.2010.02.011
11.Mahalingam P, Sambhav K. Surgical outcomes of inverted internal limiting membrane flap technique for large macular hole. Indian J Ophthalmol. 2013 Oct;61(10):601-3.https://doi.org/10.4103/0301-4738.121090
12.Charles S, Randolph JC, Neekhra A, et al. Arcuate retinotomy for the repair of large macular holes. Ophthalmic Surg Lasers Imaging Retina. 2013 Jan-Feb;44(1):69-72.https://doi.org/10.3928/23258160-20121221-15
13.Wong R, Howard C, Orobona GD. RETINA EXPANSION TECHNIQUE FOR MACULAR HOLE APPOSITION REPORT 2: Efficacy, Closure Rate, and Risks of a Macular Detachment Technique to Close Large Full-Thickness Macular Holes. Retina. 2018 Apr;38(4):660-663.https://doi.org/10.1097/IAE.0000000000001705
14.Casini G, Loiudice P, de Cillà S, et al. Sulfur hexafluoride (SF6) versus perfluoropropane (C3F8) tamponade and short term face-down position for macular hole repair: a randomized prospective study. Int J Retina Vitreous. 2016 Apr 1;2:10.https://doi.org/10.1186/s40942-016-0036-9
15.Shimada Y, Seno Y, Mizuguchi T, et al. Patient adherence to the face-down positioning after macular hole surgery. Clin Ophthalmol. 2017 Jun 8;11:1099-1104.https://doi.org/10.2147/OPTH.S135144
16.Pak KY, Park JY, Park SW, et al. Efficacy of the Perfluoro-N-Octane-Assisted Single-Layered Inverted Internal Limiting Membrane Flap Technique for Large Macular Holes. Ophthalmologica. 2017;238(3):133-138.https://doi.org/10.1159/000477823
17.Yamashita T, Sakamoto T, Terasaki H, et. al. Best surgical technique and outcomes for large macular holes: retrospective multicentre study in Japan. Acta Ophthalmol. 2018 Dec;96(8):e904-e910.https://doi.org/10.1111/aos.13795
18.Kannan NB, Parida H, et. Comparative study of inverted internal limiting membrane (ILM) flap and ILM peeling technique in large macular holes: a randomized-control trial. BMC Ophthalmol. 2018 Jul 20;18(1):177.https://doi.org/10.1186/s12886-018-0826-y
19.Briand S, Chalifoux E, Tourville E, et al. Prospective randomized trial: outcomes of SF6 versus C3F8 in macular hole surgery. Can J Ophthalmol. 2015;50:95-100.https://doi.org/10.1016/j.jcjo.2014.12.006
20.Kim SS, Smiddy WE, Feuer WJ, Shi W. Outcomes of sulfur hexafluoride (SF6) versus perfluoropropane (C3F8) gas tamponade for macular hole surgery. Retina. 2008 Nov-Dec;28(10):1408-15.https://doi.org/10.1097/IAE.0b013e3181885009
21.Rao X, Wang NK, Chen YP, et. al. Outcomes of outpatient fluid-gas exchange for open macular hole after vitrectomy. Am J Ophthalmol. 2013 Aug;156(2):326-333.e1.https://doi.org/10.1016/j.ajo.2013.03.031
22.Thompson JT, Smiddy WE, Glaser BM, et al. Intraocular tamponade duration and success of macular hole surgery. Retina. 1996;16(5):373-82.https://doi.org/10.1097/00006982-199616050-00002
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