Equivalent tamponade by room air as compared with SF₆ after macular hole surgery

Background: To evaluate the effect of tamponade by room air after vitrectomy for the treatment of idiopathic macular hole (MH). Methods: There were 156 eyes of 151 patients studied. The patients' ages ranged from 35 to 88 years old (mean:-65.1 years). After conventional pars plana vitrectomy with internal limiting membrane peeling, fluid air exchange was performed using 20% SF₆ (Gas group: 91 eyes) or room air (Air group: 65 eyes). Surgical outcomes were retrospectively analyzed. Results: Mean preoperative hole diameter was 352 μm in the Gas group and 370 μm in the Air group (P = 0.558). The closure rate of all cases was 91.0% after first surgery and 98.7% at last follow-up. The primary closure rate was 90.1% in the Gas group after 7.44 ± 1.66 (mean ± SD) days prone positioning period, and 92.3% in the Air group after 3.83 ± 0.97 days of prone positioning. There was significant difference in prone positioning period (P < 0.0001), but not in the first closure rate (P = 0.132). Conclusion: This study suggests that room air may have an equivalent tamponade effect, in spite of the shorter prone positioning period, than SF₆ after MH surgery.