Gas Injection versus Vitrectomy with Gas for Treating Retinal Detachment Owing to Macular Hole in High Myopes

Abstract

To compare the efficacy between intravitreal gas injection alone and pars plana vitrectomy (PPV) with intraocular gas tamponade in treating retinal detachment due to macular hole in high myopes. Prospective, randomized controlled, multicenter study. We included 231 eyes of 231 patients with retinal detachment owing to myopic macular hole from 14 study sites in China. The patients were randomly assigned to undergo intravitreal perfluoropropane (C3F8) gas injection (group A) or vitrectomy with intraocular C3F8 gas tamponade (group B). Complete ocular examination included best-corrected visual acuity, applanation tonometry, slit-lamp biomicroscopy, color fundus photography, ultrasound examination, and optical coherence tomography at baseline and every 3 months after the surgery. At 12 months after surgery, the retinal reattachment rates was 59.8% (52 eyes) in group A, which was significantly lower than group B (79 eyes, 74.5%; P = 0.029). Logistic regression showed that PPV (P<0.001) and low height of retinal detachment at baseline (P = 0.068) were associated with a greater retinal reattachment rate. Subgroup analysis revealed that in group B, concomitant internal limiting membrane (ILM) peeling showed a slightly higher anatomic success rate (79.2%) than no ILM peeling (70.0%). The postoperative best-corrected visual acuity of the eyes with attached retina between group A and B was not significantly different (P>0.05). Pars plana vitrectomy with C3F8 endotamponade resulted in a higher anatomic success rate than intravitreal C3F8 gas injection alone in treating retinal detachment owing to macular hole in high myopes. The authors have no proprietary or commercial interest in any materials discussed in the article.