Outcomes of sulfur hexafluoride (SF6) versus perfluoroethane (C2F6) gas tamponade for non-posturing macular-hole surgery.

Abstract

To compare the outcomes of non-posturing macular-hole surgery using sulfur hexafluoride (SF(6)) gas versus perfluoroethane (C(2)F(6)) for idiopathic macular hole repair. Design Interventional, comparative cohort study. 39 eyes of 38 patients undergoing macular-hole surgery with SF(6) were compared with another consecutive group of 39 eyes (39 patients) in whom C(2)F(6) was used. All patients were operated on by a single surgeon and underwent 23G transconjunctival phakovitrectomy with no prone posturing in the postoperative period. The best-corrected Snellen's visual acuity (VA) was converted to the logarithm of minimal angle of resolution (logmar) visual acuity for analysis. Optical coherence tomography documentation of anatomical closure and complications of surgery were recorded. Primary hole closure was achieved in 89.75% in the C(2)F(6) group and 87.2% in the SF(6) group. Secondary closure after non-posturing redo surgery with heavy oil (Oxane-HD) was 100% in both groups. The mean preoperative VA in the C(2)F(6) group and SF(6) group was 0.81 logMAR and 0.78 respectively. 2 weeks after surgey, SF(6) was completely absorbed in all cases, and the mean VA improved to 0.5 logMAR; however, it remained 1.9 logMAR in the C(2)F(6) group. The final mean VA at 6 months was 0.44 (range 0-0.78) and 0.38 (range 0-1) in the C(2)F(6) and SF(6) group respectively. There were no instances of pupillary capture in the SF(6) group, whereas there were four in the C(2)F(6) group. Macular-hole surgery with SF(6) gas achieves similar results to C(2)F(6) and is absorbed faster, allowing quicker visual rehabilitation for the patient.