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

Abstract

Purpose To compare anatomic and functional outcomes of macular hole surgery with either silicone oil or C 3F 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 3F 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 3F 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.