title: PNEUMATIC VITREOLYSIS FOR RELIEF OF VITREOMACULAR TRACTION.
abstract: OBJECTIVE
  To evaluate the outcome of perfluoropropane (C3F8) gas injection for symptomatic vitreomacular traction (VMT) with or without Stage 2 macular hole (MH).
  
  
  METHODS
  A retrospective review of eyes with VMT treated with 0.3 mL of C3F8 gas was performed. Patients avoided the supine position until gas resolution. Patients with small MH maintained partial face-down positioning.
  
  
  RESULTS
  Forty-nine consecutive patients (50 eyes) with symptomatic VMT underwent pneumatic vitreolysis between 2010 and 2016. A posterior vitreous detachment developed in 43 eyes (86.0%) after a single gas injection, at a median of 3.0 weeks. Twenty-eight of 35 eyes (80.0%) with VMT only and all 15 eyes (100%) with a small Stage 2 MH developed a posterior vitreous detachment, with MH closure in 10 of 15 eyes (66.7%). Median baseline and last best spectacle-corrected visual acuities were 20/50 and 20/40, respectively (P < 0.001). Mean follow-up time was 11.1 ± 9.9 months. Rate of posterior vitreous detachment was reduced with presence of diabetes mellitus (25%) and with thick cellophane membrane (50%). Univariate analysis showed increased VMT release for eyes with VMT extent within 1 disk area (χ = 13.1, P = 0.002), eyes with absence of diabetes mellitus (χ = 8.8, P = 0.007), and eyes with Stage 2 MH (χ = 5.47, P = 0.019); there was a trend between success and lack of thick cellophane membrane (χ = 3.32, P = 0.068). Results using logistic regression also showed younger age (P = 0.012), followed by better baseline best spectacle-corrected visual acuity (P = 0.044), lack of diabetes mellitus (P = 0.077), and female gender (P = 0.045) to be predictors of increased VMT release. One VMT-only eye formed a MH and another VMT-only eye developed a retinal detachment. Both eyes responded to vitrectomy.
  
  
  CONCLUSIONS
  Pneumatic vitreolysis with limited face-down position is a viable option for treating VMT with few adverse events. More studies are needed to elucidate its indications, benefits, and risks.
authors.affiliation: *Southern California Desert Retina Consultants, Palm Desert, California; †Department of Ophthalmology, Loma Linda University, Loma Linda, California; ‡Retina Consultants of Alabama, The University of Alabama at Birmingham, Birmingham, Alabama; §Retinal Consultants of San Antonio, San Antonio, Texas; and ¶Department of Allied Health Studies, School of Allied Health Professions, Loma Linda University, Loma Linda California.
authors.forename: Clement K
authors.initials: CK
authors.lastname: Chan
authors.forename: Jason N
authors.initials: JN
authors.lastname: Crosson
authors.forename: Calvin E
authors.initials: CE
authors.lastname: Mein
authors.forename: Noha
authors.initials: N
authors.lastname: Daher
mesh_terms: D000368:Aged; D018450:Disease Progression; D058450:Endotamponade / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D056888:Patient Positioning; D011183:Postoperative Complications; D012164:Retinal Diseases / Q000175:diagnosis / Q000601:surgery*; D012167:Retinal Perforations / Q000175:diagnosis / Q000601:surgery; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D057586:Vitreoretinal Surgery / Q000009:adverse effects / Q000379:methods*; D014822:Vitreous Body / Q000601:surgery*; D020255:Vitreous Detachment / Q000175:diagnosis / Q000209:etiology
chemical_list: D005466:Fluorocarbons; C042852:perflutren