Abstract:AIM: To compare the efficacy of vitrectomy combined with internal limiting membrane peeling and C3F8 or sterile air tamponade for idiopathic macular hole(IMH).
METHODS: In this research, 51 cases of IMH with holes diameter ≤600μm were accepted from the same doctor of department of Ophthalmology in Luoyang Central Hospital from January 2011 to January 2016. All the patients were under taken vitrectomy combined with internal limiting membrane peeling and gas tamponade. All the study subjects were divided into two groups(Group A and Group B). The Group A were tamponaded with perfluoropropane(C3F8)(27 eyes), while the Group B were tamponaded with sterile air(24 eyes).The closure rate and morphology of macular hole, the time of prone position, the best corrected visual acuity(BCVA), the improvement of metamorphopsia and the process of cataract were compared and statically analyzed in these two groups. While the closure rate was compared among ≤200μm, >200-400μm and >400-600μm groups. Postoperative followup time was 1wk, 1, 3mo and half a year.
RESULTS: The difference of two groups was no statistically significant in all interval according to holes diameter(P>0.05). The difference of two groups was no statistically significant in morphology of macular hole form(P>0.05). The time of prone position in Group B was significantly shorter than that in Group A, and the difference was statistically significant(P<0.01). The BCVA of postoperative was improved than preoperative, and the difference was statistically significant(P<0.01). However, there was not statistically significant between the two groups in the BCVA of postoperative(P>0.05). The metamorphopsia of postoperative was improved than preoperative in two groups while there was not statistically significant between the two groups in the BCVA of postoperative(P>0.05). Cataract progress rate was reduced in the Group B than the Group A, but the difference was not statistically significant(P>0.05).
CONCLUSION: This study shows that sterile air tamponade can obtain same closure rate, morphology of macular hole and the improvement of metamorphopsia and visual function in holes diameter ≤600μm when reducing the time of prone position and the risk of systemic diseases induced by prone position after operation.
