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J. T. Wilkinson, S. Bailey, D. Choi, C. J. Flaxel; Outcomes of the Surgical Repair of Macular Hole Comparing SF6 to C3F8 or C2F6. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1322.
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To compare macular hole closure rates and the presence of postoperative microholes in a group of patients receiving SF6 gas with one week of facedown positioning to a group of patients receiving C3F8 or C2F6 with longer than one week facedown positioning.
Medical records of adult patients that underwent primary pars plana vitrectomy for the repair of stage 2 to 4 idiopathic macular hole during the period of 2006 to 2009 at Oregon Health and Science University were reviewed. Preoperative and postoperative data of patients with three months to one year of follow-up were selected. Patients with a persistent, or recurrent, postoperative full-thickness macular hole were included regardless of length of follow-up. Patients with previous surgery for macular hole, and those treated with silicone oil, were excluded from the study.
Eighty eyes from 74 patients were evaluated and macular hole closure was achieved in 61 eyes (76.3%) overall. Among patients treated with SF6, hole closure was achieved in all 11 eyes. Macular holes were closed in 50 of 69 eyes (72.5%) among patients treated with C3F8 or C2F6. This difference in closure rate approaches statistical significance (p=0.058). Postoperative optical coherence tomography was reviewed in 43 of the patients with clinical closure of the full-thickness macular hole to determine the presence of a retinal microhole. A microhole was noted in 11 eyes (25.6%). Three of 11 eyes (27.3%) treated with SF6 developed a microhole compared with 8 of 33 eyes (24.2%) treated with C3F8 or C2F6 (p = 0.698). This difference was not significant.
The overall rate of macular hole closure following primary pars plana vitrectomy in this study is similar to closure rates previously reported in the literature. The rate of hole closure among patients treated with SF6 and less postoperative facedown positioning was similar to that among patients treated with the longer acting agents C3F8 or C2F6 and more extensive facedown positioning. Postoperative microholes were present in about 25% of closed macular holes in both groups.
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