Selection Criteria for Air Tamponade During Vitrectomy for Rhegmatogenous Retinal Detachment

Purpose: To compare air tamponade and sulfur hexafluoride (SF6) gas tamponade during vitrectomy for the treatment of rhegmatogenous retinal detachment (RRD). Methods: We reviewed 294 eyes with RRD treated with 25-gauge vitrectomy by a single surgeon between June 2011 and April 2018 retrospectively. The exclusion criteria for the proposed air tamponade selection were more than 2 weeks since onset, giant retinal tears, history of complications following cataract surgery, high myopia, and proliferative vitreoretinopathy classified as grade C or higher. We examined the differences in the therapeutic effect between the air group and SF6 group at 6-month follow-up. Results: A total of 294 eyes were included in the study, 156 eyes in the air group and 138 eyes in the SF6 group. No difference was observed in the primary anatomical success rates between the air group (99.4%; 155/156 eyes) and the SF6 group (96.5%; 135/138 eyes; P = 0.102). Postoperative intraocular gas half-life was shorter in the air group (3.97 +/- 0.87 days) compared with the that in the SF6 group (8.67 +/- 1.47 days; P = 0.0001). The incidence of postoperative ocular hypertension was lower in the air group (19.9%; 31/156 eyes) than in the SF6 group (62.3% 86 /138 eyes; P = 0.0001). Conclusion: We compared the criteria for proper selection between air and SF6 gas tamponade during vitrectomy for the treatment of RRD. Air tamponade was able to reduce the period of prone position and the risk of ocular hypertension without reducing the therapeutic effect.