Air versus Gas Tamponade for Primary Rhegmatogenous Retinal Detachment: A Systematic Review and Meta-Analysis

Abstract

Background: Air tamponade’s effectiveness in treatment of rhegmatogenous retinal detachment (RRD) remains unclear. Objective: We aimed to review the surgical outcomes between air and gas tamponade after vitrectomy for RRD. Method: PubMed, Cochrane Library, EMBASE, and Web of Science were reviewed. The study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42022342284). The primary outcome was the primary anatomical success after vitrectomy. The secondary outcome was the prevalence of postoperative ocular hypertension. Certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation system. Results: Ten studies involving 2677 eyes were included. One study was randomized, and the others were non-randomized. The primary anatomical success after vitrectomy was not significantly different between the air and gas groups (odds ratio [OR], 1.00; 95% confidence interval [CI], 0.68–1.48). The risk of ocular hypertension was significantly lower in the air group (OR, 0.14; 95% CI, 0.09–0.24). The certainty of evidence regarding air tamponade having an comparable anatomical outcome and lower frequency of postoperative ocular hypertension in treatment of RRD were low. Discussion: The current evidence base for tamponade selection in treatment of RRD has several major limitations. Further appropriately designed studies are needed to guide tamponade selection.

Outcomes of short- versus long-acting gas tamponades in vitrectomy for rhegmatogenous retinal detachment

“…Ten studies with 2,677 eyes were included, of which 1,556 eyes received different types of gas tamponades and the remainder an air tamponade. The reported primary anatomical success rates with gas tamponades range from 78.1 to 100% with different gas tamponades, [ 11 ] similar to our study. The lowest rate was in a prospective study with C3F8 gas tamponade in inferior breaks, with a success rate of 78.13% in 32 eyes [ 18 ].…”

“…In the current literature, air tamponades have been compared with different gas tamponades in rhegmatogenous retinal detachment with regard to re-detachment rate, with some studies reporting higher surgical success rates with gas tamponades and others finding no difference [ 1 , 10 , 11 ]. However, available comparative data on long- and short-acting gas tamponades in standard retinal detachment surgery is sparse.…”