AIR VERSUS GAS TAMPONADE IN RHEGMATOGENOUS RETINAL DETACHMENT WITH INFERIOR BREAKS AFTER 23-GAUGE PARS PLANA VITRECTOMY: A Prospective, Randomized Comparative Interventional Study.

PURPOSE To compare the efficacy of air and octafluoropropane (C3F8) in treating rhegmatogenous retinal detachments with inferior breaks after 23-gauge pars plana vitrectomy. METHODS A prospective, randomized comparative interventional study. Sixty-four patients with rhegmatogenous retinal detachment with inferior breaks underwent pars plana vitrectomy with air (32 eyes) or gas (32 eyes) tamponade. Anatomical and visual outcomes of the two groups were compared. RESULTS The mean follow-up period was 13.09 ± 1.90 months. Significant differences were identified regarding prone positioning period (P < 0.01), intraocular pressure (P < 0.01), and gas volume (P = 0.03) on the first postoperative day. The single-operation success rates for the air and gas groups were 84.38% and 78.13% (P = 0.522), and the final surgery success rates increased to 100% and 96.88% (P = 0.313), respectively. The single-operation success rate between the groups was not statistically significant, even after adjustment for confounding factors. Multivariate logistic regression also indicated that the number of involved retinal quadrants (odds ratio = 19.88, P = 0.01) was an independent predictor of surgery failure. The only postoperative complication observed was new or missed breaks, which occurred in 12 patients (18.75%). CONCLUSION Air had equivalent tamponade effects to C3F8, with a shorter prone positioning period, fewer complications, and less expense, in the surgical management of rhegmatogenous retinal detachment with inferior breaks.