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Hideaki Usui, Tsutomu Yasukawa, Hiroshi Morita, Munenori Yoshida, Yuichiro Ogura; Comparative Study of Room Air and SF6 Gas Tamponade on Functional and Morphological Recoveries After Macular Hole Surgery. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2148.
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© ARVO (1962-2015); The Authors (2016-present)
Recent studies demonstrated that tamponade by room air provided equivalent results for the treatment of macular hole, as compared with the use of expansile gas such as sulfur hexafluoride (SF6). The objective of this study is to compare the effects of room air and SF6 on functional and morphological recoveries of the macula shortly after macular hole surgery.
Twenty-two eyes of 22 consecutive cases with idiopathic macular hole with diameter less than 500 µm and the history of symptom shorter than 6 months were retrospectively reviewed. All patients underwent transconjunctival 25-gauge pars plana vitrectomy with internal limiting membrane peeling by a single surgeon (Y.O.), subsequently required to take prone posturing for SF6 gas or air tamponade. Eleven eyes were treated with tamponade by SF6 gas (SF6 group) and 11 eyes by room air (Air group). Averaged age was 60.2 ± 14.9 and 64.7 ± 4.3, respectively. Best-corrected visual acuity (BCVA) was measured. The morphology of the macula 1 month after surgery was assessed by optical coherence tomography (OCT).
Mean preoperative hole diameter was 303 ± 98 µm in the SF6 group and 227 ± 113 µm in the Air group, and the duration of symptom 2.8 ± 1.3 and 2.5 ± 1.1 months, respectively. The primary closure rate was 100% in both groups, while prone posturing period had statistically significant difference between the SF6 group with 7.0 ± 1.6 days and the Air group with 3.7 ± 0.6 days (unpaired t-test: p=0.000002). Mean BCVAs at the baseline and in months 1 and 3 were 0.25, 0.63, and 0.77 in the SF6 group; and 0.32, 0.60, and 0.73 in the Air group, respectively. BCVAs at any time points had no statistically significant difference between both groups. In month 1, the gap of the junction of inner and outer segments of photoreceptor (IS/OS) was persisted in 2 (18.2%) in the SF6 group and in 2 (22.2%) of 9 eyes with OCT image in the Air group (Fisher’s exact test: p=0.63).
This study suggests that room air tamponade may provide equivalently prompt functional and morphological recoveries as well as comparable rate of macular hole closure even with shorter prone posturing period, as compared with SF6 gas tamponade, at least for macular holes with relatively small diameters.
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