Silicone oil vs. gas for the treatment of full-thickness macular hole

The purpose of this study is to evaluate the anatomic and visual outcomes, as well as the complications, of macular hole surgery with SF6-gas tamponade versus silicone-oil tamponade. Fifty-four (54) eyes with idiopathic macular hole underwent vitrectomy and peeling of the internal limiting membrane (ILM) around the hole. Nineteen (19) eyes were treated with SF6-gas tamponade (group 1) and the other thirty-five (35) eyes with silicone-oil tamponade (group 2). An excellent anatomic success rate was obtained in both groups (94.7% in group 1 and 97.1% in group 2). Nevertheless, the postoperative visual acuity (VA) in the group treated with silicone-oil tamponade was significantly better than in the group treated with gas tamponade (P = 0.0217). Forty-seven (47) of the eyes in group 1 and 74% in group 2 achieved a VA = 0.4 or better. The most frequent potentially vision threatening complication we observed was RPE alterations in 35% of the eyes in group 1 and in only one eye in group 2. None of the eyes developed a retinal detachment during the follow-up period. In conclusion, the treatment of idiopathic macular holes by vitrectomy and ILM peeling provides a very good anatomic success rate. An excellent recovery of visual acuity, up to 1.0, was more frequently observed in the group treated with silicone oil tamponade.