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A Step by Step Protocol for Subretinal Surgery in Rabbits
Published on: September 13, 2016
Gas tamponade choice in low-to-moderate complexity primary rhegmatogenous retinal detachment: propensity-matched
Nikolaos Tzoumas1,2, Xiaoman S Li2, David Yorston3
1Sunderland Specialist Eye Hospital, Sunderland, UK.
Aims:
To compare single-operation anatomical success, postoperative visual acuity, and complications after rhegmatogenous retinal detachment (RRD) repair using sulphur hexafluoride (SF6), perfluoroethane (C2F6), or perfluoropropane (C3F8).
Methods:
We analysed British and Eire Association of Vitreoretinal Surgeons-European Society of Retina Specialists (BEAVRS-EURETINA) registry data from 2012 to 2024. After exclusions, 7466 eyes contributed to anatomical and 5734 to visual analyses. Intraocular gas tamponades were compared using propensity-score matching and weighted regression adjustment. Equivalence was tested using prespecified margins of OR 0.80-1.25 for anatomical success and ±0.10 logMAR for postoperative visual acuity.
Results:
Matched main-outcome cohorts had effective sample sizes up to 4155. For single-operation anatomical success, estimates favoured C2F6 over SF6 (OR 1.19; 95% CI 0.97 to 1.48; p=0.10), and C2F6 over C3F8 (OR 1.28; 1.01 to 1.65; p=0.048), although the CIs included effects close to the null. C3F8 showed no anatomical advantage over SF6 (OR 0.83; 0.58 to 1.13; p=0.35), with CIs compatible with possible harm. For postoperative visual acuity, C2F6 and SF6 were similar (MD -0.01 logMAR; -0.04 to 0.01; p=0.29), while C3F8 was associated with worse acuity than C2F6 (MD 0.10 logMAR worse; 0.07 to 0.14; p<0.001) and SF6 (MD 0.09 logMAR worse; 0.04 to 0.13; p<0.001). Cystoid macular oedema (CMO) was more common with C3F8 than SF6 (OR 2.72; 1.13 to 6.57; p=0.026), while raised IOP was less likely with C2F6 than C3F8 (OR 0.41; 0.24 to 0.68; p<0.001).
Conclusions:
In matched low-to-moderate complexity RRD cohorts, C2F6 and SF6 were associated with similar postoperative visual acuity. C3F8 was associated with worse postoperative visual acuity compared to both other gases, as well as increased risks of CMO compared to SF6 and of raised IOP compared to C2F6. Anatomical estimates were consistent with a possible benefit for C2F6 over the other gases, and indicated no clear advantage for C3F8.
