Comparative Analysis Of C₃F₈ And Air Filling In The Treatment Of Idiopathic Macular Hole

Objactive:To investigate the efficacy of inert gas（C₃F₈）and sterilized air as intraocular fillers in the treatment of idiopathic macular hole after vitrectomy.Method:This is retrospective case-control study.Patients who were diagnosed with idiopathic macular hole in the Ophthalmology Center of the Second Hospital of Jilin University between June 2013 and June 2020were treated with 23G pars plana vitrectomy combined with internal boundary membrane dissection and C₃F₈ or sterilized filling.A total of112 cases（115 eyes）were included,of which 50 eyes were filled with inert gas C₃F₈（inert gas group）and 65 eyes were filled with sterile air（sterilized air group）.Idiopathic macular hole patients included in the study were grouped according to macular hole closing index,macular hole size and the international vitreomacular traction study group MH stage.The closure rate of macular hole,the recovery of damaged diameter of external limiting membrane,inner segment/outer segment,and the postoperative healing morphology were compared between the inert gas group and the sterilized air group.Results:The rate of macular hole closure was 98%in the inert gas group and96.92%in the sterilized air group.There was no statistical difference in the rate of macular hole closure between the two groups（X²=0.129,p=0.719）.By MHCI grouping（MHCI>0.7、MHCI≤0.7）,inert gas and sterile air filling after IMH vitrectomy were not associated with postoperative anatomical outcome in either subgroup（X²=1.186,p=0.276;X²=0.900,p=0.343）.According to the macular hole size grouping（MIN≤400um、400<MIN<700um、MIN≥700um）,there were no statistically significant differences in the defect diameter of ELM,IS/OS and COST before surgery among the patients treated with inert gas and sterilized air in each subgroup（p>0.05）.No statistical difference in the defect diameter of ELM,IS/OS and COST was found between the two filling gases at 1 month after surgery（p>0.05）.According to the international vitreomacular traction study group MH stage grouping（stage2,3,4）,there were no statistically significant differences in preoperative defect diameter of ELM,IS/OS,and COST among patients treated with inert gas and sterilized air in each subgroup（p>0.05）.Also,there was no statistical difference in the defect diameter of ELM,IS/OS and COST between the two filling gases at 1mo after operation（p>0.05）.Conclusion:The efficacy of vitrectomy combined with sterilized air filling in the treatment of idiopathic macular hole is comparable to that of inert gas.So,sterilized air can be used as an effective vitreous cavity filler for idiopathic full-thickness macular hole surgery.