April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Comparison Of Small Gauge Macular Hole Repair Using Sulfur Hexafluoride Versus Perfluoropropane Gas Tamponade
Author Affiliations & Notes
  • Alex Yuan
    Ophthalmology, Cole Eye Institute, Cleveland, Ohio
  • Rishi P. Singh
    Ophthalmology, Cole Eye Institute, Cleveland, Ohio
  • Footnotes
    Commercial Relationships  Alex Yuan, None; Rishi P. Singh, None
  • Footnotes
    Support  Heed Ophthalmic Foundation
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 4495. doi:
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      Alex Yuan, Rishi P. Singh; Comparison Of Small Gauge Macular Hole Repair Using Sulfur Hexafluoride Versus Perfluoropropane Gas Tamponade. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4495.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : Sulfur hexafluoride gas (SF6) is more rapidly reabsorbed compared with perfluoropropane gas (C3F8), speeding up recovery after surgery and making it more tolerable for patients. However, because of its faster reabsorption rate, there is some concern that SF6 tamponade may not be as effective as C3F8 for macular hole surgery. This study compares the outcomes of small gauge macular hole repair using SF6 versus C3F8.

Methods: : A retrospective cohort study of a single surgeon’s experience was conducted. A chart review of patients undergoing repair of macular hole in 9 consecutive eyes of 8 patients (SF6 cohort) and 9 eyes of 9 patients (C3F8 cohort) was performed. Patients underwent either 23 or 25 gauge vitrectomy with staining and removal of the internal limiting membrane with indocyanine green. The difference between the postoperative and preoperative logMAR visual acuity, incidence of postoperative intraocular pressure (IOP) spikes >23, hole closure rates, and complications in the two groups were compared.

Results: : At 2-3 months postoperatively, the rate of hole closure was identical in both groups (89%). There was a mean improvement of 0.29 logMAR for the SF6 group (p=0.04) versus no improvement (logMAR=0.04) for the C3F8 group (p=0.42). There were a total of 2 incidences of postop IOP>23 in the SF6 group compared with 4 in the C3F8 group. All IOP spikes resolved over time or with discontinuation of postoperative topical steroids. There were 4 eyes which remained phakic postoperatively in the SF6 group and 3 in the C3F8 group. In the SF6 group, 2/4 (50%) of these eyes developed worsening cataracts which required cataract surgery. In the C3F8 group, 2/3 (67%) required cataract surgery. There was one incidence of nonarteritic ischemic optic neuropathy in the C3F8 group, 3 months after surgery.

Conclusions: : There were no observable differences in macular hole closure with the use of either gas suggesting that macular hole closure with small gauge vitrectomy and SF6 gas tamponade is a viable alternative to C3F8.

Keywords: macular holes • retina 
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