Efficacy of C3F8 versus silicone oil intraocular tamponade for severe highly myopic macular hole retinal detachment

Objective To compare the outcome of C3F8 versus silicone oil intraocular tamponade after pars plana vitrectomy (PPV) for the treatment of severe highly myopic macular hole retinal detachment (MHRD).Methods Thirty-two highly myopic MHRD patients (32 eyes) with extreme long axial lengths (≥ 29.0 mm)," severe" retina pigment epithelium (RPE) and chorioretinal atrophy,and posterior staphyloma who underwent PPV,were enrolled in this study.The patients were divided into two groups according to different intraocular tamponade agents:C3F8 (group A,15 eyes) and silicone oil (group B,17eyes).The patients with retinal re-detachment after surgery received PPV again.The differences of sex (P =1.000),age (t=0.444,P=0.660),best-corrected visual acuity (t=0.084,P=0.934),diopter (t=0.449,P=0.978),lens state (P=1.000),time of the symptoms (t=0.375,P=0.710) and degree of retinal detachment (x2 =0.014,P=0.907) between group A and B were not statistically significant.The anatomic reattachment of the retina,macular hole closure,and vision acuity were observed at one week,one,three,six and 12 months after surgery.Results The rates of retinal reattachment and macular hole closure were 60.00％ and 13.33 ％ in group A,82.35％ and 29.41％ in group B in the first time of surgery.There was no difference in rates of retinal reattachment and macular hole closure between two groups (P=0.243,0.402).The rates of retinal reattachment and macular hole closure were 86.67％ and 20.00％ in group A,94.12％ and 29.41％ in group B in the second time of surgery.There was no difference in rates of retinal reattachment and macular hole closure between two groups (P=0.589,0.691).Twelve months after surgery,the vision acuity improved in five eyes,unchanged in seven eyes,and decreased in three eyes in group A; the vision acuity improved in seven eyes,unchanged in eight eyes,and decreased in two eyes in group B.The differences of vision result was not statistically significant between two groups (x2 =0.209,P=0.647).Conclusion The rates of retinal reattachment and macular hole closure with silicone oil tamponade was higher than that with C3F8 tamponade in eyes with severe highly myopic MHRD,but the differences are not statistically significant. Key words: Myopia, degenerative/surgery;  Retinal detachment/surgery;  Retinal perforations/surgery;  Vitrectomy;  Noble gases/therapeutic use;  Silicone oils/therapeutic use