Macular hole surgery with short-acting gas and short-duration face-down positioning

Abstract

Purpose

To report on the outcomes of vitrectomy and sulfur hexafluoride (SF₆) gas tamponade for idiopathic macular holes with 2 days of face-down positioning.

Patients and methods

This was a prospective, nonrandomized, observational sequential case-series study on 23 consecutive patients receiving macular hole surgery using 20% SF₆ and advised to stay in a face-down position for 2 days postoperatively (SF₆ group). These patients were compared to 23 consecutive patients who had previously undergone macular hole surgery, had received 14% C₃F₈, and were advised to maintain a face-down position for 2 days (C₃F₈ group). Patients in both groups underwent vitrectomy, internal limiting membrane peeling, and fluid gas exchange using either SF₆ or C₃F_8. Preoperative and postoperative data included best corrected visual acuity recorded in LogMAR units, slit-lamp biomicroscopy, and optical coherence tomography.

Results

At a 6-month follow-up, macular hole closure was noted in 23/23 eyes (100%) and in 22/23 eyes (96%) in the SF₆ and C₃F₈ groups, respectively. The improvement in visual acuity (measured through Snellen acuity lines both preoperatively until 6 months postoperatively) was 4.08 ± 2.31 (95% confidence interval [CI]: 3.08–5.08) for the SF₆ group and 2.87 ± 2.30 (95% CI: 1.87–3.86) for the C₃F₈ group; this difference was not statistically significant (P = 0.06).

Conclusion

Vitrectomy with internal limiting membrane peeling and a short-acting gas tamponade using SF₆ with posture limitation for 2 days may give a high success rate in macular hole surgery.

Keywords:

• idiopathic macular holes
• SF₆ gas tamponade
• C₃F₈ gas tamponade

Disclosure

The authors have no proprietary interest and there was no financial support for this study.