Comparison of the effect between air tamponade and C3F8 tamponade during vitrectomy for idiopathic macular hole

Objective To compare the efficacy between air tamponade and perfluoropropane (C3F8) tamponade in vitrectomy combined with internal limiting membrane peeling for the treatment of idiopathic macular hole (IMP). Methods A retrospective analysis. The data of 179 eyes of 167 cases of IMH treated with vitrectomy combined with internal limiting membrane peeling were collected. All cases were randomly divided into 2 groups: air tamponade group, 92 eyes of 87 cases and C3F8 tamponade group, 87 eyes of 80 cases. After operation, patients kept prone position and received OCT examination when air was absorbed and the macular region could be seen. Patients were followed up at 1 week, 2 weeks and 1 month after operation. The visual acuity, intraocular pressure, hole closure rate, air absorption time, prone position time and occurrence rate of operation complications between the two groups were compared. Results The postoperative visual acuities were compared between two groups, and the difference was not statistically significant (t=-1.134, P=0.149). The exposure time of macula lutea in the air group was shorter than that in C3F8 group (t=18.750, P=0.000). The prone position time in the air group was shorter than that of C3F8 group, and the difference was statistically significant (t=11.920, P=0.001). The hole closure rate in C3F8 group was 95.70% and in the air group was 96.60%. The difference in the hole closure rate between two groups was not statistically significant (χ2=0.427, P=0.716). After operation, the high intraocular pressure occurred in 7 cases (7.61%) in C3F8 group, and 4 cases (4.60%) in air group, the difference between two groups was not statistically significant (χ2=0.947, P=0.364). Conclusion For the treatment of IMH, the efficacy of air tamponade and C3F8 tamponade are similar. Two surgeries can obtain better visual acuity and high hole closure rate. But the air tamponade method is with shorter absorption time, shorter prone position time, less postoperative complication and less cost. Key words: Macular hole, idiopathic; Vitrectomy; Peeling, internal limiting membrane; Tamponade, air, perfluoropropane (C3F8); Prone position