Comparison of silicone oil versus gas tamponade in the treatment of idiopathic full-thickness macular hole.

PURPOSE: To compare anatomic and functional outcomes of macular hole surgery with either silicone oil or C(3)F(8) gas tamponade. DESIGN: Retrospective comparative interventional study. PARTICIPANTS: 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. METHODS: Demographics, preoperative and postoperative characteristics, and complications were analyzed. MAIN OUTCOME MEASURES: Preoperative and postoperative visual acuity, initial hole closure, number of persistent or recurrent holes, number of reoperations, and final hole closure. RESULTS: 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). CONCLUSIONS: 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.

Duke Scholars

Author Sandra Sue Stinnett Biostatistics & Bioinformatics, Division of Biostatistics

Author Brooks W. McCuen II Ophthalmology, Vitreoretinal Diseases & Surgery