Efficacy Of C3F8Versus Silicone Oil Intraocular Tamponade For Highly Myopic Macular Hole Retinal Detachment

Objective:To compare the outcome of C3F8versus silicone oil intraoculartamponade after pars plana vitrectomy(PPV)for the treatment of highly myopicmacular hole retinal detachment(MHRD)．Methods:30highly myopic MHRD patients who underwent PPV in ourhospital from March2012to January2014,were enrolled in this study. Thepatients were all initial surgery, and randomly divided into two groups accordingto different intraocular tamponade agents: C3F8(group A,15eyes)and siliconeoil(group B,15eyes).Ocular examinations were done before and after surgery,such as slit-lamp microscope,90D mirror front lamp, three-mirror contact lensexamination, indirect ophthalmoscope, best-corrected visual acuity(BCVA),intra-ocular pressure, A and B ultrasonic scan, optical coherencetomography(OCT), et al. Patients in group A underwent vitrectomy, internallimiting membrane(ILM)peeling and14%C3F8gas injection; patients in groupB underwent vitrectomy, internal limiting membrane (ILM)peeling and siliconeoil tamponade. The anatomic reattachment of the retina, macular hole closure, BCVA and postoperative complications were observed at one week, two weeks,three weeks, one month after surgery, time of observation was no less than onemonth. Compare the outcome of C3F8versus silicone oil intraocular tamponadeafter PPV for the treatment of MHRD. The correlation between the structuralchanges of macular and postoperative BCVA was analyzed. All results wereanalyzed statistically by SPSS16.0.Results:1.The rates of retinal reattachment and macular hole closure were86.67％and20.00％in group A,93.33％and66.67％in group B in the firsttime of surgery. There was no difference in rates of retinal reattachment betweentwo groups(P=1.000).The difference of macular hole closure between twogroups was statistically significant (P=0.025). The rate of macular hole closurewith silicone oil tamponade was higher than that with C3F8tamponade.2.Thepostoperative logMAR-BCVA was1.27±0.35in group A, and0.97±0.29ingroup B, the difference of vision result was statistically significant between twogroups(t=-2.541,P=0.017).The BCVA in group B was higher than groupA.3.The rates of BCVA improvement were92.30%in patients who received acontinuous IS/OS afer surgery,47.06%in patients with a fracture IS/OS, thedifference of vision improvement was statistically significant betweenthem(P=0.017). The rate of BCVA improvement in patients with a continuousIS/OS was higher than patients with a fracture IS/OS.4.Postoperativecomplications: The rates of complicated cataract and high intraocular pressurewere20.00％and13.33％in group A,33.33％and40.00％in group B.There were no differences in rates of complicated cataract and high intraocularpressure between two groups(P=0.682,P=0.215)．Conclusions: There are no difference of the rates of retinal reattachmentbetween patients with gas tampenade and silicone oil tamponade. The rates of macular hole closure and best-corrected visual acuity with silicone oiltamponade was higher than that with C3F8tamponade in eyes with highlymyopic macular hole retinal detachment.The recovery of visual function aftersurgery of patients with highly myopic macular hole retinal detachment hasclose correlation with the continuity of the IS/OS.