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Scott Sullivan, Brett Budden, Aravinda Rao; Incidence of recurrent vitreous hemorrhage with SF6 vs air post-vitrectomy. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2803.
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While the gas sulfur hexafluoride (SF6) is commonly used for mechanical tamponade in the treatment of retinal tears, its effectiveness as a hemostatic agent for primary vitreous hemorrhage (PVH) is not well studied. We performed a retrospective comparative analysis to test the hypothesis that the use of SF6 is superior to tamponading with air in regards to decreasing rebleeding and reoperation rates following pars plana vitrectomy (PPV) for PVH.
We performed an analysis of medical record data for patients who underwent vitrectomy surgery for vitreous hemorrhage over five years (2010 – 2015) at the Vitreoretinal Institute (VRI) of Baton Rouge, Louisiana. Eyes with post-operative recurrent vitreous hemorrhages were identified. Tamponade agent and the need for reoperation were recorded for primary analysis. Patient age, gender, and aspirin use were recorded for demographic data. Exclusion criteria included prescription anticoagulant use, blood disorders, eyes that underwent vitrectomy for indications unrelated to hemorrhage, recent history of intraocular surgery, use of silicone oil or C3F8, and patients with less than 6 weeks follow-up. Relationships between the variables was analyzed using the chi-squared test of association.
Of the 104 eyes eligible for this study, 28 received SF6 for tamponade and 76 received air. Thirty eyes experienced recurrent vitreous hemorrhage after initial surgery and 12 required reoperation. There was no significant difference between SF6 and air for rates of either RVH (28.86% vs 28.9%; p=.970), or need for re-operation (17.9% vs 9.2%; p=.221).
Our study revealed that SF6 was not more effective than air in the prevention of recurrent vitreous hemorrhage or re-operation when comparing eyes having undergone vitrectomy with SF6 vs air tamponades secondary to PVH. As our review involved a limited number of patients (n=104) and was retrospective in nature, a larger prospective study is needed to confirm this relationship.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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