Efficacy of C3F8 versus silicone oil tamponade in highly myopic macular hole retinal detachment

Abstract:

AIM: To compare the outcome of C₃F₈ versus silicone oil tamponade after pars plana vitrectomy(PPV)and inverted internal limiting membrane(ILM)for the treatment of highly myopic macular hole retinal detachment(MHRD).

METHODS: Retrospective clinical study. Totally 45 patients(45 eyes)with highly myopic MHRD who visited our hospital between January 2019 and August 2022 were selected as the research subjects. The patients were divided into two groups according to different intraocular tamponade agents: C₃F₈(22 eyes)and silicone oil(23 eyes)groups. All patients underwent conventional three-incision PPV, ILM was tamped, a venous blood clot was placed on the tamped ILM, and 15% C₃F₈ and silicone oil were used as tamponade, respectively. The best corrected visual acuity(BCVA), multifocal electroretinogram(mfERG), the closure of the macular hole, retinal reattachment and the complications were observed.

RESULTS: The macular hole closure rate was 77% in the C₃F₈ group and 83% in the silicone oil group, respectively(P>0.05), and retinal reattachment rates were 95% and 96%, respectively(P>0.05). The visual acuity of the two groups significantly improved, which was 0.99±0.34 and 1.22±0.37, respectively, and the C₃F₈ group was better than that of the silicone oil group(t=-2.156, P=0.037). After operation, the response density of the first ring of P1 wave in the first order kernel in mfERG was 114.27±26.37 nV/deg² for the C₃F₈ group and 98.08±24.36 nV/deg² for the silicone oil group, and the response density of the second ring of P1 wave was 80.45±14.94 nV/deg² for the C₃F₈ group and 67.73±15.33 nV/deg² for the silicone oil group, all of which were significantly higher compared to pre-operation \〖the response density of the first ring of P1 wave: 58.13±13.96 nV/deg² for the C₃F₈ group and 55.30±10.48 nV/deg² for the silicone oil group, the response density of the second ring of P1 wave: 51.18±8.19 nV/deg² for the C₃F₈ group and 47.43±11.97 nV/deg² for the silicone oil group\〗(all P<0.05). It was found that the response density of the first ring of P1 wave was lower in the silicone oil group than in the C₃F₈ group(P<0.05). There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).

CONCLUSION: Silicone oil tamponade or C₃F₈ tamponade after PPV combined with ILM can both promote retinal reattachment and macular hole closure in patients with MHRD, and the C₃F₈ tamponade was superior to silicone oil in visual function recovery.