Comparative Study of Different Techniques of Intraocular Gas Tamponade in the Treatment of Retinal Detachment due to Macular Hole (With 1 color plate)

Abstract

The injection of sulfur hexafluoride (SF₆) or perfluoropropane (C₃F₈) was used as a method of internal tamponade in 43 eyes affected by retinal detachment due to macular hole. The technique of ocular hypotension prior to gas injection varied according to the characteristics of each case, using vitrectomy and SF₆ 30% in 8 cases (group 1), fluid-gas (SF6) exchange through the pars plana in 10 cases (group 2) paracentesis of the anterior chamber prior to injection of SF₆ in 12 cases (group 3) and injection of C₃F₈ without drainage in 13 cases (group 4). Retinal reattachment was initially achieved in 87 (group 1), 83.3 (group 2), 100 (group 3) and 92.3% (group 4), but 4 recurrences yielded a 6-month follow-up cure of 75 (group 1), 75 (group 2), 91 (group 3) and 84% (group 4). Postoperative complications included proliferative vitreoretinopathy (7%), endophthalmitis (2.3%) and subretinal hemorrhage (2.3%). The use of intraocular gas tamponade appears to be a procedure with an acceptable complication rate in the treatment of retinal detachment due to macular hole. This study suggests the use of paracentesis and SF₆ in phakic eyes, C₃F₈ in aphakic eyes and vitrectomy plus 30% SF₆ in eyes with proliferative vitreoretinopathy or vitreoretinal traction adjacent to the macular hole.