AIM: To compare the efficacy of air versus silicone oil tamponade for management of rhegmatogenous retinal detachment(RRD)following 25G pars plana vitrectomy(PPV).

METHODS: A prospective, randomized comparative study. 146 eyes from 146 patients who underwent 25G transconjunctival sutureless vitrectomy to repair rhegmatogenous retinal detachment were performed. Totally 60 eyes used air tamponade but 86 eyes used silicone oil tamponade. The follow-up time ranged from 6-12mo. The best corrected visual acuity(LogMAR), intraocular pressure, retinal reattachment rate, intraoperative and postoperative complications were compared.

RESULTS: One month after surgery, the mean BCVA was 0.45±0.5 in the air tamponade group and 0.78±0.65 in the silicone oil tamponade group, it were both evidently improved in comparison with before surgery, what's more, air tamponade had significantly better BCVA than those in the silicone oil tamponade(both P<0.05). 3mo after surgery, the reattachment rate of patients in air group was lower than that of silicone oil group(93.3% vs 97.7%), but had no significant differences between the two groups. 6mo after surgery, the anatomical success rate were 100% in both groups. The main intraoperative complication was iatrgenic retinal breaks in 10 eyes(6.8%). The main postoperative complication was high intraocular pressure, the intraocular pressure 1wk after surgery in the silicone oil tamponade group was evidently higher than that air tamponade group(P<0.001). No serious complication such as endophthalmitis and choroidal hemorrhage were observed in both groups.

CONCLUSION: For the simple early RRD, air tamponade had equivalent reattachment rate to silicone oil tamponade after 25G PPV. In the early postoperative, the visual acuity of air group was better comparing with silicone oil group, and was lower incidence of high intraocular pressure.