KASMEJ

Kastamonu Medical Journal regularly publishes internationally qualified issues in the field of Medicine in the light of up-to-date information.

EndNote Style
Index
Original Article
Outcomes of 25-gauge pars plana vitrectomy using silicone oil versus C3F8 gas tamponades in rhegmatogenous retinal detachment
Aims: To compare the visual and anatomical outcomes, intraocular pressure (IOP) changes, and complications of 25-gauge pars plana vitrectomy (PPV) using silicone oil (SO) versus perfluoropropane (C3F8) gas tamponade in the management of rhegmatogenous retinal detachment (RRD).
Methods: This retrospective study analyzed 43 eyes of 43 patients treated with 25-gauge PPV for RRD. Patients were divided into two groups: Group 1 (SO, n=25) and Group 2 (C3F8 gas, n=18). Visual acuity, IOP, and postoperative complications were evaluated over a 52-week follow-up period. Statistical comparisons were conducted using the SPSS software, and a significance level of p<0.05.
Results: Both groups demonstrated significant improvements in best-corrected visual acuity (BCVA) at the 52nd week. Mean BCVA improved from 2.23 ± 0.89 logMAR to 0.30 ± 0.21 logMAR in the SO group and from 2.07 ± 0.87 logMAR to 0.19 ± 0.05 logMAR in the C3F8 group. Recurrent retinal detachment was observed in 8% of SO cases and 16.7% of C3F8 cases, with successful reattachment achieved in all reoperations. IOP increased mildly in the SO group but decreased significantly in the C3F8 group. Anti-glaucomatous therapy was initiated in 16% of patients in the SO group and 16.7% in the C3F8 group.
Conclusion: Both SO and C3F8 gas tamponades are effective in achieving visual and anatomical success following 25-gauge PPV for RRD. C3F8 gas demonstrated better IOP stabilization, whereas SO was effective for more complex cases. These findings support the tailored use of tamponades based on individual patient and disease characteristics.


1. El-Abiary M, Shams F, Goudie C, Yorston D. The Scottish RD survey 10 years on: the increasing incidence of retinal detachments. Eye (Lond). 2023;37(7):1320-1324. doi:10.1038/s41433-022-02123-1
2. El-Batarny AM. Transconjunctival sutureless 23-gauge vitrectomy for vitreoretinal diseases: outcome of 30 consecutive cases. Middle East Afr J Ophthalmol. 2008;15(3):99-105. doi:10.4103/0974-9233.51983
3. Lewis SA, Miller DM, Riemann CD, Foster RE, Petersen MR. Comparison of 20-, 23- and 25-gauge pars plana vitrectomy in pseudophakic rhegmatogenous retinal detachment repair. Ophthalmic Surg Lasers Imag. 2011;42(2):107-113. doi:10.3928/15428877-20101223-02
4. Oshima Y, Wakabayashi T, Sato T, Ohji M, Tano Y. A 27-gauge instrument system for transconjunctival sutureless microincision vitrectomy surgery. Ophthalmology. 2010;117(1):93-102.e2. doi:10.1016/j.ophtha.2009.06.043
5. Nam Y, Chung H, Lee JY, Kim JG, Yoon YH. Comparison of 25- and 23-gauge sutureless microincision vitrectomy surgery in the treatment of various vitreoretinal diseases. Eye (Lond). 2010;24(5):869-874. doi:10. 1038/eye.2009.206
6. Saleh OA, Alshamarti SA, Abu-Yaghi NE. Comparison of characteristics and clinical outcomes in 27-gauge versus 23-gauge vitrectomy surgery. Clin Ophthalmol. 2020;14:1553-1558. doi:10.2147/OPTH.S255162
7. Nagpal M, Wartikar S, Nagpal K. Comparison of clinical outcomes and wound dynamics of sclerotomy ports of 20, 25, and 23 gauge vitrectomy. Retina. 2009;29(2):225-231. doi:10.1097/IAE.0b013e3181934908
8. Romano MR, Zenoni S, Arpa P, Mariotti C. Mixture of ether and silicone oil for the treatment of inferior complicated retinal detachment. Eur J Ophthalmol. 2013;23(2):230-235. doi:10.5301/ejo.5000215
9. Schoenberger SD, Riemann CD. Profound postoperative hypotony with globe collapse after 25-gauge pars plana vitrectomy. Retin Cases Brief Rep. 2012;6(4):415-418. doi:10.1097/ICB.0b013e31824f70f6
10. dell&rsquo;Omo R, Scupola A, Viggiano D, et al. Incidence and factors influencing retinal displacement in eyes treated for rhegmatogenous retinal detachment with vitrectomy and gas or silicone oil. Invest Ophthalmol Vis Sci. 2017;58(6):BIO191-BIO199. doi:10.1167/iovs.17-21466
11. Moharana B, Dogra M, Singh SR, et al. Outcomes of 25-gauge pars plana vitrectomy with encircling scleral band for acute retinal necrosis-related rhegmatogenous retinal detachment. Indian J Ophthalmol. 2021;69(3): 635-640. doi:10.4103/ijo.IJO_1353_20
12. &Ouml;zal E, Baybora H, Karapapak M, et al. Unveiling macular displacement: endotamponade variations in retinal detachment repair outcomes. Int Ophthalmol. 2024;44(1):412. doi:10.1007/s10792-024-03351-y
13. Vitrectomy with silicone oil or perfluoropropane gas in eyes with severe proliferative vitreoretinopathy: results of a randomized clinical trial. Silicone study report 2. Arch Ophthalmol. 1992;110(6):780-792. doi:10. 1001/archopht.1992.01080180052028
14. Lee SH, Han JW, Byeon SH, et al. Retinal layer segmentation after silicone oil or gas tamponade for macula-on retinal detachment using optical coherence tomography. Retina. 2018;38(2):310-319. doi:10.1097/IAE.0000000000001533
15. McCuen BW 2nd, Azen SP, Stern W, et al. Vitrectomy with silicone oil or perfluoropropane gas in eyes with severe proliferative vitreoretinopathy. Silicone study report 3. Retina. 1993;13(4):279-284. doi:10.1097/00006982-199313040-00002
16. Ge L, Su N, Fan W, Yuan S. Risk factors and management of intraocular pressure elevation after vitrectomy combined with silicone oil tamponade. Int J Gen Med. 2024;17:447-456. doi:10.2147/IJGM.S446617
17. Fan W, Zhang C, Ge L, et al. Prediction model for elevated intraocular pressure risk after silicone oil filling based on clinical features. Front Med (Lausanne). 2024;10:1340198. doi:10.3389/fmed.2023.1340198
18. Wen X, Yang N, Zhang Y, MA W, FU Y, Geng R. Efficacy of C3F8 versus silicone oil tamponade in highly myopic macular hole retinal detachment. Int Eye Sci. 2024;12:805-809.
19. Syeda S, Segar S, Abrams GW, Lin X. Surgical timing of fovea-off diabetic tractional detachment repair and outcomes. Invest Ophthalmol Vis Sci. 2024;65(7):3216-3216.
Volume 5, Issue 1, 2025
Page : 70-75
_Footer