[Vitreoretinal surgery with intraocular C3F8 tamponade for retinal detachment due to macular hole without face-down positioning].

OBJECTIVE

To evaluate the effectiveness of vitreoretinal surgery with 16% perfluoropropane (C3F8) tamponade without face-down positioning in treatment of retinal detachment due to macular hole.

METHODS

Twenty-seven consecutive eyes in 27 patients with retinal detachment due to myopic macular hole underwent closed vitrectomy, membrane peeling, gas-fluid exchange with C3F8 tamponade in the whole vitreous chamber. In 3 eyes, phacoemulsification was performed, and 2 of them received intraocular lens implantation. Postoperatively, except avoiding the supine position, the body position was not restricted.

RESULTS

Twenty-one cases (78%) obtained successful retinal reattachment without the postoperative face-down positioning. In another 6 cases, because of the relatively quick absorption of the gas, the white macular hole and the subretinal proliferation, the operation was not successful, the hole being not sealed and the retinal detachment at the lower part still existing. In the 3 cases with quick absorption of the gas, on the 10th day after the operation, the body position was changed into a face-down one. In 2 of them, the retinal reattachment occurred. After > 6 months of follow-up, the retinal reattachment remain the same in 22 cases (81%), the macular hole was healed, and the visual acuity was elevated to > or = 0.1 in 19 cases. The main complications were lens opacity in 6 cases (31%), temporary elevation of intraocular pressure in 3 cases (11%).

CONCLUSION

Use the methods for the treatment of macular hole and retinal detachment mentioned above may obtain relatively good therapeutic results, particularly suitable for senile and unhealthy cases.