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

Objective: 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. Design: Prospective, randomized controlled, multicenter study. Participants: We included 231 eyes of 231 patients with retinal detachment owing to myopic macular hole from 14 study sites in China. Intervention: The patients were randomly assigned to undergo intravitreal perfluoropropane (C3F8) gas injection (group A) or vitrectomy with intraocular C3F8 gas tamponade (group B). Main Outcome Measures: 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. Results: 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). Conclusions: 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. Financial Disclosure(s): The authors have no proprietary or commercial interest in any materials discussed in the article. Ophthalmology 2009;116:1182-1187 (C) 2009 by the American Academy of Ophthalmology.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000266906500022&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=8e1609b174ce4e31116a60747a720701OphthalmologySCI(E)PubMed23ARTICLE61182-118711