title: Anatomical and functional results of macular hole retinal detachment surgery in patients with high myopia and posterior staphyloma treated with perfluoropropane gas or silicone oil.
abstract: OBJECTIVE
  To evaluate the use of perfluoropropane gas (C3F8) versus silicone oil (SO) for retinal detachment secondary to macular hole in patients with high myopia and posterior staphyloma.
  
  
  METHODS
  In a retrospective study, 30 eyes of 30 patients underwent pars plana vitrectomy, and C3F8 (17 patients) or SO (13 patients) tamponade; internal limiting membrane peeling was performed successfully at the first surgery in 23 patients. High-density silicone oil tamponade was used for reoperations.
  
  
  RESULTS
  The mean values of patients' characteristics were as follows: age, 57.7 years; axial length, 29.02 mm; spherical equivalent refraction, -15.40 diopters; initial best-corrected visual acuity, 2.35 logarithm of the minimum angle of resolution; final best-corrected visual acuity, 1.59 logarithm of the minimum angle of resolution. In C3F8 group, best-corrected visual acuity significantly improved (P < 0.001), passing from 2.34 to 1.36 logarithm of the minimum angle of resolution. Vision improvement from blindness to low vision was significantly greater (P = 0.009) in C3F8 group (16 of 17; 94%) than in SO group (6 of 13; 46%). A significant higher initial success (P = 0.025) was found in the C3F8 group (16 of 17; 94%) than in the SO group (7 of 13; 54%). Proliferative vitreoretinopathy was the cause of initial failure; all these subjects achieved anatomical success after being reoperated with high-density silicone oil tamponade.
  
  
  CONCLUSIONS
  C3F8 and internal limiting membrane peeling could represent the most effective strategy in highly myopic patients with macular hole retinal detachment. Other tamponade agents must be investigated.
authors.affiliation: Ophthalmology Unit, Tor Vergata Foundation Medical Center, University of Rome Tor vergata, Rome, Italy. mancino@med.uniroma2.it
authors.forename: Raffaele
authors.initials: R
authors.lastname: Mancino
authors.forename: Elena
authors.initials: E
authors.lastname: Ciuffoletti
authors.forename: Alessio
authors.initials: A
authors.lastname: Martucci
authors.forename: Francesco
authors.initials: F
authors.lastname: Aiello
authors.forename: Claudio
authors.initials: C
authors.lastname: Cedrone
authors.forename: Luciano
authors.initials: L
authors.lastname: Cerulli
authors.forename: Carlo
authors.initials: C
authors.lastname: Nucci
mesh_terms: D000368:Aged; D001485:Basement Membrane / Q000601:surgery; D004108:Dilatation, Pathologic; D058450:Endotamponade; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000150:complications*; D057972:Posterior Eye Segment / Q000473:pathology*; D012163:Retinal Detachment / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D012167:Retinal Perforations / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012827:Silicone Oils / Q000008:administration & dosage*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
chemical_list: D005466:Fluorocarbons; D012827:Silicone Oils; C042852:perflutren