Outcomes of sulfur hexafluoride (SF₆) versus perfluoroethane (C₂F₆) gas tamponade for non-posturing macular-hole surgery

Abstract

Macular-hole surgery with SF(6) gas achieves similar results to C(2)F(6) and is absorbed faster, allowing quicker visual rehabilitation for the patient.

The Case Mix of Patients Presenting with Full-Thickness Macular Holes and Progression before Surgery: Implications for Optimum Management

“…There is general consensus that ILM peeling improves primary anatomical hole closure rate and is now widely practiced but some surgeons do not peel ILM if hole size is <400 μm because of the potential of iatrogenic harm from the peeling procedure [3,4,13,14]. The need for posturing is debated with many studies showing successful non-posturing surgery in holes <400 μm and often with the use of short-acting gases [5,15,16,17,18]. Large holes are still usually treated with longer-acting gases and posturing [5,6,7,19,20] although the requirement for posturing is debated and a further study is needed [21].…”

Macular hole treatment

“…Most studieson this topic confirm the ophthalmologists preference for gas tamponade in the last 15 years (19). Air tamponade is the most often technique used in vitreoretinal surgery for retinal detachment, vitreous haemorrhage, epiretinal membrane etc.…”

“…Seven days positioning also implies significant higher medical and social costs, poorer compliance and major patient discomfort. Se recent studies analysed the posibility of avoiding dorsal postoperative positioning and the good outcomes suggest that positioning is less important as long as the surgical technique is very good (19,22). However, these results need to be confirmed by future similar studies.…”

“…Pneumatic retinopexy uses expandable gas (usually C3F8 or SF6) and remains the first choice in MH surgical treatment. Once injected intravitrealy, expandable gases increase their volume and persist longer in the vitreal cavity, up to 4-6 weeks (9,19). If associated with long term postoperative head positioning, they provide a better retinal tamponade on the hole edges.…”

Individualized, Spectral Domain-Optical Coherence Tomography–guided Facedown Posturing After Macular Hole Surgery

“…4,11,12,[24][25][26][27][28] The results of recent comparative studies 12,[26][27][28] suggested no statistically significant difference in the closure rates between no posturing or short-term posturing and standard posturing. However, there was a tendency for the closure rate to be better with standard posturing than with no or short-term posturing, for example, posturing versus no posturing was 97.4% versus 87.5% in a study by Guillaubey et al 26 27 Nonetheless, these results must be questioned because 800 cases are theoretically required to achieve a 95% confidence interval.…”