title: Outcomes of outpatient fluid-gas exchange for open macular hole after vitrectomy.
abstract: OBJECTIVE
  To report the efficacy and safety of outpatient fluid-gas exchange for open macular hole after primary vitrectomy.
  
  
  METHODS
  Retrospective interventional case series.
  
  
  METHODS
  setting: Institutional. patients: Thirty-six patients with primary failed closure or reopened holes after primary vitrectomy. intervention: Fluid-gas excahnge with 15% perfluoropropane (C3F8) or 20% sulfur hexafluoride (SF6) was performed to reclose the hole under topical anesthesia. main outcome measures: The hole closure rate and type, pre- and postexchange best-corrected visual acuity (BCVA), and complication rates were assessed.
  
  
  RESULTS
  Thirty-two eyes (89%) achieved anatomic success from 1-3 weeks after the fluid-gas exchange. Twenty-two eyes (61%) achieved type 1 closure, 10 eyes (28%) achieved type 2 closure, and 4 eyes (11%) did not achieve closure. The BCVA for type 1 closure improved significantly from logarithm of the minimal angle of resolution (logMAR) 1.66 ± 0.41 to 0.84 ± 0.41, with a P value <.001. The BCVA for type 2 closure improved from logMAR 1.77 ± 0.41 to 1.52 ± 0.41, with a P value of .05. All patients with an unclosed hole after fluid-gas exchange had a stage IV macular hole before the primary vitrectomy and a hole size larger than 1000 μm. The complication related to fluid-gas exchange procedure was transient high intraocular pressure, which responded well to topical antiglaucoma medications. There were 2 retinal detachment cases following the exchange; surgery to reattach the retina was performed, with visual acuity recovery.
  
  
  CONCLUSIONS
  Outpatient fluid-gas exchange is an effective treatment option for eyes with open holes following vitrectomy.
authors.affiliation: Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.
authors.forename: Xi
authors.initials: X
authors.lastname: Rao
authors.forename: Nan-Kai
authors.initials: NK
authors.lastname: Wang
authors.forename: Yen-Po
authors.initials: YP
authors.lastname: Chen
authors.forename: Yih-Shiou
authors.initials: YS
authors.lastname: Hwang
authors.forename: Lan-Hsin
authors.initials: LH
authors.lastname: Chuang
authors.forename: I-Chia
authors.initials: IC
authors.lastname: Liu
authors.forename: Kuan-Jen
authors.initials: KJ
authors.lastname: Chen
authors.forename: Wei-Chi
authors.initials: WC
authors.lastname: Wu
authors.forename: Chi-Chun
authors.initials: CC
authors.lastname: Lai
mesh_terms: D000328:Adult; D000368:Aged; D058450:Endotamponade; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011183:Postoperative Complications; D012008:Recurrence; D012167:Retinal Perforations / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D013459:Sulfur Hexafluoride / Q000008:administration & dosage*; D041623:Tomography, Optical Coherence; D017211:Treatment Failure; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
chemical_list: D005466:Fluorocarbons; C042852:perflutren; D013459:Sulfur Hexafluoride