A Comparative Study of Vitrectomy Combined with Internal Limiting Membrane Peeling for the Treatment of Idiopathic Macular Hole with Air or C3F8 Intraocular Tamponade

Chen, Xiang; Yao, Yi; Hao, Xiaolu; Liu, Xiaocui; Liu, Tiecheng

doi:10.1155/2018/1672501

Cited by 15 publications

(16 citation statements)

References 23 publications

(27 reference statements)

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“…There was a significant increase in the IOP in operated eyes between baseline and postoperative day 2, which seems to be due to the effect of surgery itself, such as corneal edema or postoperative inflammation. In addition, as noted in previous studies [17][18][19], the IOP increase in surgically treated eyes could be attributed to the influence of FDP. Furthermore, the IOP significantly decreased between postoperative days 2 and 7 in both eyes, but the degree of descent was higher in the contralateral eyes.…”

Section: Plos Onesupporting

confidence: 72%

Intraocular pressure change with face-down positioning after macular hole surgery

2020

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This study evaluated changes in intraocular pressure (IOP) with face-down positioning (FDP) following surgical treatment of idiopathic macular hole. We retrospectively reviewed the records of 130 patients diagnosed with idiopathic macular hole who underwent pars plana vitrectomy (PPV) with intravitreal gas injection after fluid-gas exchange. We analyzed IOP changes in both eyes following FDP over the course of 7 days. The mean IOP of the operated eyes was 14.98±2.95 mmHg preoperatively and 16.82±3.12 and 15.57±6.10 mmHg on postoperative days 2 and 7, respectively. In contralateral eyes, the mean IOP changed from 14.78±3.15 mmHg preoperatively to 16.27±1.87 and 14.40±4.14 mmHg on postoperative days 2 and 7, respectively. On postoperative day 2, the IOP increased in both eyes compared to the preoperative values, but the increase was significant only in operated eyes (p = 0.039). In contralateral eyes, the IOP on postoperative day 7 was significantly decreased compared with that on postoperative day 2 (p = 0.021) and in eyes with an axial length ≥ 23.0 mm, compared with the preoperative values (p = 0.042). The IOP of the operated eyes on postoperative day 7 was higher than that of the contralateral eyes (p = 0.039). Based on a short-term follow-up, FDP after PPV with intravitreal gas tamponade for the treatment of idiopathic macular hole may cause IOP elevation not only in the operated, but also in the contralateral eyes; the IOP increase in contralateral eyes was not as significant as that in operated eyes and was not maintained over 7 days after surgery; the IOP change seems to be affected by axial length and lens status.

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Section: Plos Onesupporting

confidence: 72%

Intraocular pressure change with face-down positioning after macular hole surgery

2020

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“…To maximize the effects of gas and improve the closure rate of macular hole, long-lasting gas tamponades, such as SF6, C2F6, and C3F8, are used as standard practice in macular hole surgery [20]. Recently, some studies have demonstrated that room air can have similar outcomes to long-lasting gas, but the conclusions of these studies are limited because they only macular holes with small diameters were included [8,9,10]. Gesseret al reported that the initial closure rate for air as a tamponade for MH surgery was only 79%, about 10% lower than that reported in other studies with long-acting gas tamponades [11].…”

Section: Resultsmentioning

confidence: 99%

“…Lens opacification was another complication of intraocular gas filling, Chen et al found a higher rate of transient lens opacity in the C3F8 group than that of air group after the surgery [10]. Studies showed that cataract surgery performed after macular hole repair could cause complications due to intraoperative difficulties during phacoemulsification, which arise from the absence of vitreous support in a vitrectomized eye and the increased risk of zonular and/or posterior capsular insult [24].Moreover, cataract surgery following macular hole repair may lead to postoperative reopening of the macular hole in about 20% of patients, especially if there are complications involving cystoid macular edema.…”

Section: Resultsmentioning

confidence: 99%

“…Hideaki et al found that room air filling may provide equally prompt functional and morphological recovery as well as a comparable rate of MH closure compared with SF6 gas tamponade, especially for smaller macular hole [8,9]. Chen et al demonstrated that the effect of air as an intraocular tamponade material can be similar to that of C3F8 with fewer complications [10]. However, Gesser et al found that the air tamponade effectiveness is poor [11].…”

Section: Introductionmentioning

confidence: 99%

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A Comparative Study of Vitrectomy Combined with Internal Limiting Membrane Peeling for Idiopathic Macular Hole of different hole diameters with Air or C3F8 Intraocular Tamponade

Tang

Lin

et al. 2019

Preprint

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Background：Vitrectomy and membrane peeling followed by gas filling technique has become a standard procedure of macular hole surgery, the outcomes are affected by many factors, and which kind of intraocular tamponade is the best choice still has some conflicts. The purpose of this study is to investigate whether air filling can achieve comparable effects to long-acting inert gases when different macular hole sizes are enrolled. Methods：116 patients with idiopathic macular hole were enrolled in this retrospective study, 44 received C3F8 tamponade and 72 received sterile air tamponade. Before and after vitrectomy surgery, the best corrected visual acuity, slit lamp examination, fundus examination and intraocular pressure were analyzed. Results：No statistically significant difference was fund in age, gender, axial length, intraocular pressure, or preoperative visual acuity between groups. After the surgery, the closure rates of air group and C3F8 group with macular hole diameter ≤400 microns were 94.4% and 100.0%, with no significant difference between the two groups (P = 0.701). The closure rates of macular hole diameters lager than 400 microns are 66.7% and 91.3%, P = 0.029. The total closure rates of the two groups are 80% and 95.6%, P =0.018. Conclusions：In idiopathic macular hole surgery, the effect of air as an intraocular tamponade material is similar to that of C3F8 in macular hole with diameters less than 400 microns. In patients with larger macular hole (diameter over 400 microns) performed therapeutic surgery with air filling, internal limiting membrane insertion or flap inversion may be recommended get better outcomes.

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“…The use of air tamponade to successfully treat small MHs has been described in some studies. [9][10][11][12] However, air is still used very rarely for large MHs. In this study, sterile air was used as a tamponade for medium-large MHs, and the results indicate that this surgical approach achieved favourable results, suggesting that air tamponade is a safe and effective treatment for medium-large MHs.…”

Section: Discussionmentioning

confidence: 99%

Pars plana vitrectomy with air tamponade for the treatment of medium‐large macular holes

Cheng

Zou

Zhang

et al. 2020

Clinical and Experimental Optometry

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Background: To evaluate the surgical outcomes of pars plana vitrectomy (PPV) with air tamponade in medium-large macular holes (MHs). Methods: Data for 26 eyes of 26 consecutive patients with medium-large full-thickness MHs (> 400 μm) who underwent PPV, internal limiting membrane (ILM) peeling, and sterile air tamponade were studied retrospectively. Best-corrected visual acuity and the closure rate were noted. The follow-up period was one to 20 months (median, four months). Results: The age range of the patients was 53-73 years (median, 65 years). The mean minimum diameter of the MHs was 550 AE 99 μm. Prior to surgery, 10 eyes (38 per cent) were stage three, and 16 eyes (62 per cent) were stage four. The pre-operative symptom duration ranged from one month to 24 months (median, four months). Twenty-four MHs (92.3 per cent) were successfully closed after a single operation. Two (7.7 per cent) patients had a persistent MH. The average visual acuity, calculated as the logarithm of the minimal angle of resolution, improved from 1.44 AE 0.45 pre-operatively to 0.54 AE 0.29 at the end of the follow-up period (p < 0.001, paired t-test). Conclusion: Vitrectomy with ILM peeling and sterile air tamponade is an effective and safe surgical technique for managing medium-large MHs with a shorter history and does not require intravitreal long-acting gas tamponade while maintaining a long-term, face-down position.

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A Comparative Study of Vitrectomy Combined with Internal Limiting Membrane Peeling for the Treatment of Idiopathic Macular Hole with Air or C3F8 Intraocular Tamponade

Cited by 15 publications

References 23 publications

Intraocular pressure change with face-down positioning after macular hole surgery

Intraocular pressure change with face-down positioning after macular hole surgery

A Comparative Study of Vitrectomy Combined with Internal Limiting Membrane Peeling for Idiopathic Macular Hole of different hole diameters with Air or C3F8 Intraocular Tamponade

Pars plana vitrectomy with air tamponade for the treatment of medium‐large macular holes

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