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Observational Study
. 2025 Feb 5;25(1):61.
doi: 10.1186/s12886-024-03839-2.

Efficacy of a simple intravitreal perfluoropropane injection in treating unclosed idiopathic macular holes following vitrectomy

Zexia Dou  1 , Jindong Han  2 , Shaozhen Zhao  3
Affiliations
Observational Study

Efficacy of a simple intravitreal perfluoropropane injection in treating unclosed idiopathic macular holes following vitrectomy

Zexia Dou et al. BMC Ophthalmol. .

Abstract

Background: This study aimed to evaluate the efficacy of a simple intravitreal injection of perfluoropropane (C3F8) in treating unclosed idiopathic macular holes (IMHs) in patients who had previously undergone primary pars plana vitrectomy (PPV).

Methods: This study was a retrospective, observational clinical study. It included patients diagnosed with unclosed IMHs following primary PPV combined with internal limiting membrane peeling and air tamponade. Optical coherence tomography (OCT) performed 1 week after PPV revealed unclosed IMHs with the presence of the 'cuff' sign and intraretinal cysts. The following day, these patients received a simple intravitreal C3F8 injection. Comprehensive evaluations, including best-corrected visual acuity (BCVA), indirect ophthalmoscopy, fundus photography, and OCT, were performed before PPV, 1 week after surgery, and at follow-up intervals of 1-3 months after the intravitreal gas injection.

Results: The minimum linear diameter (MLD) of the macular holes (MHs) 1 week before C3F8 injection was 335.1 ± 74.3 μm. Following C3F8 tamponade, the closure rate of the MHs was 100%. The mean BCVA before C3F8 tamponade was 0.68 ± 0.17 logMAR (20/100) after primary PPV, which improved to 0.48 ± 0.19 logMAR (20/63) after C3F8 tamponade, showing a statistically significant difference (P = 0.01).

Conclusions: For patients with unclosed MHs after primary PPV, the presence of the 'cuff' sign on OCT suggests that retreatment can be effectively achieved through a simple intravitreal gas injection. This approach is straightforward, practical, and effective.

Keywords: C3F8; Idiopathic macular hole; Intravitreal gas injection; Long-acting gas perfluoropropane; Pars plana vitrectomy; Primary pars plana vitrectomy; Unclosed idiopathic macular hole.

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Conflict of interest statement

Declarations. Ethics approval: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Tianjin Medical University Eye Hospital (2023KY(L)-25). Consent to participate: Informed consent was obtained from all individual participants included in the study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Serial images of case 1 before and after pars plana vitrectomy (PPV) and after intravitreal C3F8 injection a Ultra-wide-field fundus image demonstrating a full-thickness macular hole (MH). b–e Serial optical coherence tomography (OCT) images of the case. b Preoperative OCT showing an idiopathic full-thickness MH before PPV. c One week after PPV, OCT revealed a reduction in the MH size and absorption of subretinal fluid. d One week after intravitreal gas injection, OCT indicated MH closure. e During follow-up after the intravitreal gas injection, complete closure of the MHs was achieved
Fig. 2
Fig. 2
Serial images of case 2 before and after pars plana vitrectomy (PPV) and after intravitreal C3F8 injection. a Colour fundus photograph illustrating a full-thickness macular hole (MH). b–e Serial optical coherence tomography (OCT) image of the case. b Preoperative OCT revealing an idiopathic full-thickness MH with cystoid changes at the edges. c One week after PPV, OCT indicated non-closure of the MH, with minimal intraretinal cysts still present. d One week after intravitreal gas injection, OCT showed closure of the MH, although some disorganisation of the foveal microstructure persisted. e Three months after the intravitreal gas injection, OCT demonstrated that the macular hole was closed and foveal microstructure had improved
See this image and copyright information in PMC

References

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