Exclusive Use of Air as Gas Tamponade in Rhegmatogenous Retinal Detachment

Abstract

Purpose To investigate outcomes of vitrectomy for rhegmatogenous retinal detachment (RRD) using air exclusively as the gas tamponade. Methods This retrospective, interventional, consecutive case series involved reviewing medical records of patients that underwent vitrectomy and gas tamponade for RRD between January 2013 and December 2015. Patients whose eyes were treated exclusively with air tamponade since July 2014 were assigned to the air group, while those treated with heterogeneous gas agents before June 2014 were assigned to the control group. The primary outcome was the primary reattachment rate. Best-corrected visual acuity (BCVA) and duration to detect redetachments were assigned as the secondary outcomes. Results The air group and the control group included 71 and 72 eyes, respectively. The primary reattachment rate was 94.4% in the air group and there was no significant difference with 94.4% in the control group (p = 0.951). BCVA was significantly better in the air group at 1 month (p = 0.021) but not at 3 months postoperatively (p = 0.561). Redetachments were recognized earlier in the air group (9.3 ± 0.5 days) compared with those in the control group (21.3 ± 7.4 days) (p = 0.041). Conclusions In cases of simple RRD with sufficient removal of subretinal fluid, air could be considered for use as gas tamponade. This trial is registered with KCT0002358.

Complications Associated with the Use of Expandable Gases in Vitrectomy

“…In addition to possible complications associated with long-acting gases, other disadvantages include their cost, the time, and workload required to acquire and store them and additional surgical time for dilution and administration. Several studies assessed the utility of air tamponade for eyes undergoing vitreoretinal surgery [57, 58]. A significant advantage of applying air compared to expandible gases is a shorter prone-positioning and recovery period.…”

“…Zhang et al reported similar success rate RRDs with superior retinal breaks in eyes with partial and complete air tamponade [60]. In other studies, air was used exclusively for tamponade in vitrectomy for RD, resulting in the similar reattachment rate in inferior breaks as well [57, 58]. Nevertheless, the majority of primary uncomplicated RRDs remain treated with expandible gas tamponade.…”

Scleral buckling in the management of rhegmatogenous retinal detachment: patient selection and perspectives

“…Even after the advent of pars plana vitrectomy (PPV), which was introduced as a new treatment option by Robert Machemer,5 SB had been the standard technique for RRD for several decades, and PPV was considered as a supplemental procedure to SB in complicated cases, such as proliferative vitreoretinopathy (PVR). Evolution of vitrectomy machines and related instruments has significantly increased the application of PPV in recent years 6–10…”

<p>Fortified Barrier Laser On The Vitreous Base In Vitrectomy For Rhegmatogenous Retinal Detachment</p>

“…Long-acting non-expansible gases (SF 6 , C 3 F 8 ) were used as the tamponade agents in the CBL group more frequently, whereas room air was used in most cases in the FBL group which included more recent operations. However, we reported that the use of air for tamponade in RRD was not inferior to that of perfluorinated gases in a previous study,27 although long-acting gas is, in general, expected to be more efficacious than room air in RRD 28. This fact suggests that the difference in the tamponade gas would not be a confounding factor that might result in a higher SSSR in the FBL group.…”