Comparative Observation Of Macular Microstructure After Vitrectomy Combined With Inert Gas Or Sterile Air Filling In The Treatment Of IdioPathic Macular Hole

Objective:To compare the microstructure and vision improvement of sterile air and inert gas used for intraocular filling after vitrectomy for treatment of idiopathic macular hole.Method:Retrospective case-control study.From January 2012 to December 2018,109 patients(114eyes)with idiopathic macular hole diagnosed with concurrent vitrectomy in the second hospital of Hebei Medical University were selected,48 eyes were filled with sterile air and the remaining 88eyes were filled with 10%or 13%C3F8(inert gas group).The best-corrected visual acuity(BCVA),the minimum diameter of the macular hole,defect diameter of external limiting membrane(ELM),inner segment/outer segment(IS/OS)and cone outer segment tips(COST)were compared between the two groups.Statistical analysis was performed..Results:Preoperative BCVA(0.92±0.37、0.99±0.32)(P=0.697),minimum hole diameter of macular hole(295.82±89.15、313.84±99.83)(P=0.317),defect diameter of ELM layer(813.16±276.36、841.11±274.96)(P=0.307),IS/OS layer(1634.70±449.66、1691.61±509.91)(P=0.231)and COST layer(1911.82±455.62、1990.40±530.90)(P=0.219)showed no statistical difference between the air group and the inert gas group(P>0.05).There was no statistical difference in the closure rate at 1 month(X~2=1.011,P=0.315)after surgery.There was no significant difference in the best-corrected visual acuity in the air group between different healing in histomorphology and each postoperative follow-up time(P=0.476>0.05).There was no statistical difference in each index between the two groups at 2 weeks and 1 month after operation(P>0.05).The BCVA and the damage diameter of COST were no significantlly different at 3 month after operation(P<0.05),but there was significantlly difference in the defect diameter of ELM(P=0.000)and IS/OS(P=0.002)(P<0.05).There was statistically significant difference between the two groups in postoperative and preoperative BCVA(P=0.000),the defect diameter of ELM(P=0.008),IS/OS(P=0.000)and COST(P=0.000)(P<0.05).Conclusions:The long-term efficacy and safety of vitrectomy combined with sterile air tamponade for idiopathic macular hole is not significantly different from that of inert gas(C3F8),so air can replace inert gas and achieve satisfactory microstructure and visual acuity improvement.