Patel Shriji N, Law Janice, Cherney Edward, Recchia Franco, Kim Stephen J
Department of Ophthalmology, Vanderbilt University School of Medicine, Nashville, TN, USA.
Tennessee Retina, Nashville, TN, USA.
J Vitreoretin Dis. 2020 Mar 27;4(5):360-363. doi: 10.1177/2474126420914276. eCollection 2020 Sep-Oct.
This work investigates the visual and anatomical outcomes of full-thickness macular hole (FTMH) repair surgery using air in comparison to gas tamponade.
A retrospective consecutive review of medical records was undertaken of all patients undergoing pars plana vitrectomy for idiopathic FTMH at an academic practice from January 2010 to May 2017. Each operative report was reviewed to investigate the agent used for tamponade at the end of the surgery. Preoperative hole duration and size as measured using optical coherence tomography as well as successful postoperative hole closure were recorded. Use of gas or air was not randomized and was instilled at surgeon discretion.
The final analysis included 211 eyes. Gas was used as the tamponade agent in 171 of the 211 eyes; most of these eyes (144 of 171) received sulfur hexafluoride (SF) and the remainder received perfluoropropane (CF). Forty eyes underwent only a complete fluid-air exchange without any gas placement following vitrectomy. There was no statistically significant difference between the 2 groups in mean preoperative macular hole size ( = .43). Nine of the 171 macular holes receiving gas tamponade failed to close (5.3%). One of the 40 macular holes receiving only air failed to close (2.5%). There was no statistically significant difference in hole closure rates between the 2 groups ( = .45).
Air served as an equally efficacious internal tamponade agent in comparison to nonexpansile gas following idiopathic FTMH repair surgery.
本研究旨在比较使用空气与气体填塞进行全层黄斑裂孔（FTMH）修复手术的视觉和解剖学结果。
对2010年1月至2017年5月在一家学术机构接受特发性FTMH玻璃体切割术的所有患者的病历进行回顾性连续分析。每份手术报告均经过审查，以调查手术结束时用于填塞的药物。记录术前使用光学相干断层扫描测量的裂孔持续时间和大小以及术后裂孔成功闭合情况。气体或空气的使用未随机化，由外科医生自行决定注入。
最终分析纳入211只眼。211只眼中171只使用气体作为填塞剂；其中大部分眼（171只中的144只）接受六氟化硫（SF），其余接受全氟丙烷（CF）。40只眼在玻璃体切除术后仅进行了完全的液气交换，未放置任何气体。两组术前黄斑裂孔平均大小无统计学显著差异（=0.43）。171只接受气体填塞的黄斑裂孔中有9只未闭合（5.3%）。40只仅接受空气的黄斑裂孔中有1只未闭合（2.5%）。两组裂孔闭合率无统计学显著差异（=0.45）。
在特发性FTMH修复手术后，与非膨胀性气体相比，空气作为一种同样有效的内部填塞剂。
