Pars Plana Vitrectomy and Perfluoropropane (C3F8) Tamponade for Retinal Detachment Due to Myopic Macular Hole: A Prognostic Factor Analysis

Am J Ophthalmol. 2006 Dec;142(6):938-44. doi: 10.1016/j.ajo.2006.07.056. Epub 2006 Sep 1.

Abstract

Purpose: To determine the prognostic factors associated with anatomical success in the treatment of retinal detachment (RD) due to myopic macular hole by pars plana vitrectomy (PPV) and perfluoropropane (C3F8) gas tamponade.

Design: Retrospective, interventional, comparative case series.

Methods: In an institutional setting, 57 eyes with myopic macular hole RDs treated by PPV and C3F8 tamponade, with or without concomitant internal limiting membrane (ILM) peeling, endolaser photocoagulation, and/or phacoemulsification, were analyzed. Outcome measures were anatomical success, defined as closure of macular hole with reattachment of the surrounding retina, and postoperative best-corrected visual acuity (BCVA).

Results: The mean postoperative follow-up was 26.9 +/- 16.5 months. The anatomical success rate after primary PPV and C3F8 tamponade was 63.2%. Regression analysis showed that shorter axial lengths (odds ratio [OR] = 6.73, 95% confidence interval [95% CI] 1.86 to 12.22, P = .010), concomitant ILM peeling (OR 1.59, 95% CI 1.14 to 2.38, P = .013), and shorter duration of macular hole RD (OR 0.81, 95% CI 0.67 to 0.98, P = .033) were associated with a higher anatomical success. The mean pre- and postoperative BCVAs were 1.430 +/- 0.273 (range, 0.523 to 1.700) and 1.403 +/- 0.271 (range, 0.699 to 1.800) logarithm of minimal angle of resolution units, respectively. The postoperative BCVA was significantly better in eyes with macular hole closure than in eyes without (P = .021).

Conclusions: Axial length, concomitant ILM peeling, and duration were important prognostic factors for PPV and C3F8 tamponade in the treatment of myopic macular hole RDs.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Combined Modality Therapy
  • Female
  • Fluorocarbons / administration & dosage*
  • Humans
  • Male
  • Middle Aged
  • Myopia / complications*
  • Postoperative Complications
  • Prognosis
  • Reoperation
  • Retinal Detachment / etiology
  • Retinal Detachment / physiopathology
  • Retinal Detachment / surgery*
  • Retinal Perforations / complications*
  • Retrospective Studies
  • Visual Acuity / physiology
  • Vitrectomy / methods*

Substances

  • Fluorocarbons
  • perflutren