Indications and outcomes for intravitreal injection of C3F8 gas for symptomatic vitreomacular traction

Josef Guber,Ivo Guber,Celine Rusch,Hendrik P N Scholl,Christophe Valmaggia

doi:10.1038/s41598-021-97639-z

Abstract

To evaluate the indications and outcomes of perfluoropropane (C3F8) gas injection for symptomatic vitreomacular traction (VMT). A retrospective analysis of eyes with VMT treated with 0.3 mL of C3F8 gas was performed. Patients were not asked to posture after gas injection. In phakic patients, cataract surgery was performed simultaneously. Patients were examined after one week and one month postoperatively. Twenty-nine consecutive eyes of 26 patients with symptomatic VMT who underwent pneumatic vitreolysis were included. A complete posterior vitreous detachment was achieved in 18 eyes (62.1%) after a single gas injection at the final visit. The rate of posterior vitreous detachment was reduced significantly with the presence of epiretinal membrane (ERM) (p = 0.003). Three eyes formed a macular hole (MH) postoperatively and another eye developed a retinal detachment. Mean visual acuity increased significantly after one month (p < 0.008). Pneumatic vitreolysis is a viable option for treating VMT with few adverse events. Patient with concomitant ERM had a significantly lower success rate.

Highlights

To evaluate the indications and outcomes of perfluoropropane (C3F8) gas injection for symptomatic vitreomacular traction (VMT)
The VMT release already occurred within 1 week and the visual acuity went from 0.8 preoperative to 1.0 within that week, so no additional follow-up took place
Pneumatic vitreolysis (PVL) by intravitreal gas injection was introduced by Chan et al.[15]

Summary

Introduction

To evaluate the indications and outcomes of perfluoropropane (C3F8) gas injection for symptomatic vitreomacular traction (VMT). Twenty-nine consecutive eyes of 26 patients with symptomatic VMT who underwent pneumatic vitreolysis were included. A complete posterior vitreous detachment was achieved in 18 eyes (62.1%) after a single gas injection at the final visit. The rate of posterior vitreous detachment was reduced significantly with the presence of epiretinal membrane (ERM) (p = 0.003). Management options for VMT include observation, pars plana vitrectomy (PPV), enzymatic vitreolysis with ocriplasmin injection and new pneumatic vitreolysis (PVL). PPV is up to now the gold standard in treatment of symptomatic VMT with high success rates and good postoperative visual acuity. PPV is associated with some intra- and postoperative complications including cataract formation in phakic eyes, retinal detachment, endophthalmitis, and FTMH formation. Pars plana vitrectomy is cost-intensive and often associated with general anaesthesia and h ospitalisation[5,6,7,8,9]

Methods

Results

Conclusion