SF6 compared to C2F6 for inferior rhegmatogenous retinal detachment repair; The Manchester Pseudophakic Retinal Detachment Study

Abstract

Purpose- To compare SF6 relative to C2F6 in the anatomical and functional outcomes following pars plana vitrectomy (PPV) for uncomplicated primary pseudophakic rhegmatogenous retinal detachment (PRD) with inferior causative breaks. Methods- This is a retrospective, comparative study on eyes with PRD with inferior causative breaks that had small-gauge PPV repair using SF6 and C2F6 tamponade between 2011-2020 at a tertiary centre in the UK. Primary outcome was single surgery anatomical success (SSAS) and the secondary outcomes, best-corrected visual acuity (BCVA). Propensity score matching (PSM), using preoperative findings as covariates to account for relevant confounders, was performed. Results- From 162 PRD eyes with inferior causative breaks, the median (interquartile range) follow-up was 82 (52-182) days. The SSAS was 156 (96.3%) overall; 47/47 (100.0%) and 109/115 (94.8%) in the SF6 and C2F6 groups, respectively (p=0.182). Relative to the SF6 group, the C2F6 group had a higher mean number of tears (SF6:3.1[2.0], C2F6:4.5[2.7], p=0.002) and greater RD extent (SF6:5.3[2.9], C2F6:6.2[2.6] clock hours, p=0.025). Following PSM analysis, 80 eyes were matched with 40 in each group to homogenise preoperative factors. No significant difference was found in SSAS and BCVA between groups following PSM. Conclusions- Primary PPV with gas tamponade leads to a high SSAS rate in uncomplicated PRD with inferior causative breaks with no additional benefit associated with long-acting tamponade when comparing C2F6 with SF6.