Air versus Sulfur Hexafluoride Gas Tamponade for Small and Medium-Sized Macular Holes

Lindtjørn, Birger; Krohn, Jørgen; Haugstad, Marta; Stene-Johansen, Ingar; Austeng, Dordi; Basit, Sammy; Varhaug, Pål; Kvaløy, Jan Terje; Forsaa, Vegard Asgeir

doi:10.1016/j.oret.2022.04.003

Cited by 8 publications

(5 citation statements)

References 30 publications

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“…Hasegawa et al [ 9 ] included patients with a mean hole diameter of 352 μm in the SF6 group and 370 μm in the air group, who achieved a similar closure rate of around 91.0%. Recently, there is a multicenter, randomized controlled, non-inferiority study suggesting that air tamponade is inferior to SF 6 tamponade for MHs of ≤ 400 μm in diameter [ 21 ], which is in contrast to our result. However, there are certain differences between the two studies in the sample size and baseline data including age, course of disease, and so on, which may lead to different conclusions.…”

Section: Discussioncontrasting

confidence: 99%

Vitrectomy with sulfur hexafluoride versus air tamponade for idiopathic macular hole: a retrospective study

Yao

Yan

et al. 2023

BMC Ophthalmol

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Background To evaluate the effect of room air and sulfur hexafluoride (SF6) gas in idiopathic macular hole(MH)surgery. Methods Retrospective, interventional, and comparative study. 238 eyes with the idiopathic macular hole that underwent pars plana vitrectomy, internal limiting membrane peeling, fluid-air exchange, and 20% SF6 (SF6 group:125 eyes) or room air tamponade (air group: 113 eyes) were reviewed. The primary outcome measure was the closure rate of primary surgery. Results The baseline characteristics of the SF6 group and air group were comparable except for the hole size (479.90 ± 204.48 vs. 429.38 ± 174.63 μm, P = 0.043). The anatomical closure rate was 92.8% (116 / 125) with the SF6 group and 76.1% (86 / 113) with the air group (P < 0.001). A cut-off value of MH size to predict primary anatomical closure was 520 μm, which is based on the lower limit of 95% confidential interval of the MH size among the unclosed patients in the air group. There was no significant difference in anatomical closure rates between SF6 and air group (98.7% vs. 91.9%, P = 0.051) for MH ≤ 520 μm, whereas a significantly lower anatomical closure rate was shown in the air group than SF6 group (46.2% vs. 84.0%, P < 0.001) for MH > 520 μm. Conclusion SF6 exhibited more effectiveness than air to achieve a good anatomical outcome for its longer tamponade when MH > 520 μm.

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Section: Discussioncontrasting

confidence: 99%

Vitrectomy with sulfur hexafluoride versus air tamponade for idiopathic macular hole: a retrospective study

Yao

Yan

et al. 2023

BMC Ophthalmol

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“…As a short-acting expandable gas, the duration of SF6 in the eye is 13 to 24 days, slightly longer than that of air (10-11 days). 27 In recent years, most surgeons in their practice change from a long-acting gas (C3F8) at the initial time of surgery, gradually to an intermediate-acting gas (C2F6), or even a short-acting gas (SF6) and air. 6 Studies have shown that SF6 results in similar anatomical success rates for idiopathic macular holes compared with C3F8 and C2F6.…”

Section: Discussionmentioning

confidence: 99%

“…6,28 Compared with air, several studies have concluded that there is no significant difference between SF6 and air in the anatomical and functional prognosis of macular holes, at least in small-and medium-sized macular holes. 6,27,29,30 However, the mean face-down time of SF6 is longer than that of air. 29,30 This may illustrate that SF6 has some advantages in the treatment of large macular holes.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Air Versus Perfluoropropane Intraocular Tamponade Combined With Vitrectomy for the Treatment of Macular Hole in High Myopia

Zhang

Yang

Wang

et al. 2023

Retina

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Purpose: To compare the efficacy of air and perfluoropropane (C3F8) with pars plana vitrectomy (PPV) in highly myopic macular holes (HMMHs) and explore the factors related to surgical prognosis.Methods: A retrospective comparison of a consecutive series of HMMHs undergone vitrectomy and internal limiting membrane peeling. According to tamponade type, they were divided into air group and C3F8 group, which were further divided into subgroups based on hole diameter or axial length (AXL). Anatomical and functional outcomes were compared between tamponades. Related factors of initial closure rate and postoperative best-corrected visual acuity (BCVA) were analyzed by logistic regression.Results: The baseline characteristics in air group (n = 63) and C3F8 group (n = 37) were similar except the age of air was older (P = 0.019). The mean follow-up period was 17.16 6 17.97 months. After surgery, the initial closure rate of air group was 85.7% and that of C3F8 group was 83.7% (P = 0.780). And the initial closure rate showed no difference between tamponades in the same subgroup classified by hole diameter or AXL (all P . 0.05). Postoperative BCVA improved significantly in both groups (P , 0.001), but no difference between them (P = 0.793). Logistic regression showed that age, minimum linear diameter, and AXL were risk factors of initial closure rate, and preoperative BCVA was the only factor associated with postoperative BCVA (all P , 0.05).Conclusion: With a long-term follow-up of HMMH, we found air had a similar tamponade effect anatomically and functionally compared with C3F8. Air may also be a good choice for patients with HMMH.

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“…A strong consensus was reached to perform complete vitrectomy in cases of FTMH surgery, showing that surgeons in our panel were not comfortable in adopting subtotal vitrectomy (Tarakcioglu et al, 2019). A strong consensus was reached on the use of gas instead of air in FTMH, even though this practice is still debated in the literature, and one could have expected a higher percentage of disagreement to be present (Lindtjørn et al, 2022; Patel et al, 2020). Any degree of cataract associated to the FTMH was preferably operated in the same session as vitrectomy.…”

Section: Discussionmentioning

confidence: 99%

Macular hole Delphi consensus statement (MHOST)

Confalonieri,

Haave,

Binder

et al. 2023

Acta Ophthalmologica

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PurposeTo derive a Delphi method‐based consensus for the surgical management of Full Thickness Macular Hole (FTMH) and Lamellar Macular Hole (LMH).Methods37 expert VR surgeons from 21 mainly European countries participated in Delphi method‐based questionnaire for diagnosis and treatment of FTMHs and LMHs.ResultsA total of 36 items were rated in round 1 by 37 participants, of which 10 items achieved consensus: intraoperative verification of PVD; clinical superiority of OCT‐based FTMH classification; practical ineffectiveness of ocriplasmin; circular 360° ILM peeling for small macular holes; use of regular surgical technique for the size of the hole in concomitant retinal detachment; performing complete vitrectomy; SF6 gas as preferred tamponade; cataract surgery if crystalline lens is mildly/moderately opaque; removal of both ILM and LHEP in LMH surgery. In round 2, 18 items with moderate consensus (45‐70% agreement) in round 1 were rated by 35 participants. Final consensus was reached in 35% of questions related to both diagnosis and surgical procedures.ConclusionsThis Delphi study provides valuable information about the consensus/disagreement on different scenarios encountered during FTMH and LMH management as a guide tosurgical decision‐making. High rate of disagreement and/or variable approaches still exist for treating such relatively common conditions.

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Air versus Sulfur Hexafluoride Gas Tamponade for Small and Medium-Sized Macular Holes

Cited by 8 publications

References 30 publications

Vitrectomy with sulfur hexafluoride versus air tamponade for idiopathic macular hole: a retrospective study

Vitrectomy with sulfur hexafluoride versus air tamponade for idiopathic macular hole: a retrospective study

Comparison of Air Versus Perfluoropropane Intraocular Tamponade Combined With Vitrectomy for the Treatment of Macular Hole in High Myopia

Macular hole Delphi consensus statement (MHOST)

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