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Philip J. Banerjee, Aman Chandra, David G. Charteris; Gas vs Oil for Giant Retinal Tears; a comparison of visual and surgical outcome. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2622.
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Silicone oil is the most common choice of tamponade agent used when managing giant retinal tears. In addition to its well documented side effects which include glaucoma and keratopathy, concern exists regarding its potential detrimental effect on vision particularly after its removal. This mechanism remains unexplained and is of particular concern in patients whose fovea remains attached. Aims: To compare the visual and surgical outcomes in patients undergoing a primary vitrectomy for a giant retinal tear, with either oil or gas
A retrospective case note review was performed on all patients presenting to Moorfields eye Hospital with a giant retinal tear between 01/09/05 to 31/08/10. Data was entered onto an electronic database and results were subjected to appropriate statistical analyses.
124 eyes of 118 patients were identified with 100% data retrieval. 90% were male (p=<0.0005) with a mean age of 45.5yrs and median follow up of 24 months. Sub analysis was performed on two groups of patients where the fovea remained attached (Silicone Oil n= 30, Gas n=16) and where baseline characteristics were matched to compare visual and surgical outcomes; visual loss (>2 snellen lines) was observed in 58 % of silicone oil patients but only 13% of gas patients(p= 0.0082).73% in the gas group achieved a final vision of 6/12 or better, with only 26% in the oil group(p=0.008). No difference was observed in the number of procedures to achieve reattachment. No complications were observed in 67% (n=10) of gas patients compared with only 19% of patients in the oil group (p= 0.008).
In our matched cohort of macula-on GRT patients, those treated with gas had a better visual outcome with fewer complications than those treated with silicone oil.
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