Lai James C, Stinnett Sandra S, McCuen Brooks W
Department of Ophthalmology, Duke Eye Center, Duke University Medical Center, Durham, North Carolina, USA.
Ophthalmology. 2003 Jun;110(6):1170-4. doi: 10.1016/S0161-6420(03)00264-1.
To compare anatomic and functional outcomes of macular hole surgery with either silicone oil or C(3)F(8) gas tamponade.
Retrospective comparative interventional study.
Fifty-four eyes of 51 patients underwent pars plana vitrectomy for macular holes. Thirty-one eyes were treated with silicone oil tamponade, and 23 eyes were treated with C(3)F(8) tamponade.
Demographics, preoperative and postoperative characteristics, and complications were analyzed.
Preoperative and postoperative visual acuity, initial hole closure, number of persistent or recurrent holes, number of reoperations, and final hole closure.
The silicone oil and gas tamponade groups were demographically similar. The rate of hole closure after one operation with oil tamponade was significantly lower than that with gas tamponade (65% vs. 91%; P = 0.022). The percentage of patients undergoing a second operation was significantly higher in the oil group (35% vs. 4%; P = 0.006). However, with reoperations, the final rate of hole closure was similar between the oil and gas groups (90% vs. 96%; P = 0.628). The final median visual acuity for the gas group was significantly better than for the oil group (20/50 vs. 20/70; P = 0.047).
C(3)F(8) gas proved to be a more effective tamponade than silicone oil with respect to achieving initial closure of macular holes. Eyes receiving an oil tamponade required significantly more reoperations to achieve a similar rate of hole closure compared with eyes undergoing a gas tamponade. Final visual acuity was better for gas-operated eyes than for silicone-operated eyes.
比较硅油或C3F8气体填塞的黄斑裂孔手术的解剖和功能结果。
回顾性比较干预性研究。
51例患者的54只眼接受了黄斑裂孔的玻璃体切除术。31只眼采用硅油填塞治疗，23只眼采用C3F8填塞治疗。
分析人口统计学资料、术前和术后特征及并发症。
术前和术后视力、初始裂孔闭合情况、持续性或复发性裂孔数量、再次手术次数及最终裂孔闭合情况。
硅油组和气体填塞组在人口统计学上相似。一次手术使用油填塞后的裂孔闭合率显著低于气体填塞组（65%对91%；P = 0.022）。油组接受二次手术的患者百分比显著高于气体组（35%对4%；P = 0.006）。然而，经过再次手术后，油组和气体组的最终裂孔闭合率相似（90%对96%；P = 0.628）。气体组的最终中位视力显著优于油组（20/50对20/70；P = 0.047）。
在实现黄斑裂孔的初始闭合方面，C3F8气体被证明是比硅油更有效的填塞物。与接受气体填塞的眼睛相比，接受油填塞的眼睛需要显著更多的再次手术才能达到相似的裂孔闭合率。气体手术眼的最终视力优于硅油手术眼。
