Journal of Ophthalmology / 2019 / Article / Tab 1

Review Article

Sulfur Hexafluoride (SF6) versus Perfluoropropane (C3F8) in the Intraoperative Management of Macular Holes: A Systematic Review and Meta-Analysis

Table 1

Publications reporting on clinical outcomes of macular hole repair using either SF6 or C3F8 gas tamponade.

Study [Ref]YearDesignNumber of patientsPostoperative face-down positioning durationGas concentrationILM peelingAnatomical closureResults: primary closureResults: visual improvementResults: complications

Modi et al. [6]2017Retrospective comparative studySF6: 67
C3F8: 111Total: 177
SF6: 45 minutes of every hour (duration NR)
C3F8: 45 minutes of every hour (duration NR)
20% SF6
13% C3F8
All casesSF6: 86.4%
C3F8: 86.5%
Similar (), irrespective of hole size, stage, or durationSF6: 2.7 lines (0.900 ± 0.383 to 0.629 ± 0.375 logMAR) at 3–6 months
C3F8: 4.2 lines (1.03 ± 0.39 to 0.61 ± 0.40 logMAR) at 3–6 months
No significant difference ()
SF6 exhibited a decreased incidence of cataract and ocular hypertension (1.99 vs. 4.02 mmHg) as well as a nonsignificantly lower incidence of glaucoma (9.0% vs. 6.1%)
Casini et al. [3]2016Randomized controlled trialSF6: 70
C3F8: 77
Total: 147
SF6: 2 days
C3F8: 2 days
20% SF6
14% C3F8
All casesSF6: 90%
C3F8: 91%
Similar, independent of stageSF6: 5.9 lines (0.894 to 0.301 logMAR) at 1 month
C3F8: 6.9 lines (0.965 to 0.272 logMAR) at 1 month
Patients treated with SF6 experienced greater improvement of visual acuity at 1 week postoperatively () but not at 1 month
Essex et al. [4]2016Registry-based studySF6: 1,653
C3F8: 702
Total: 2,456
SF6: 0–14 days
C3F8: 0–14 days
NR97.7% of casesMean of both 95.0% (individually NR)SF6 noninferior, regardless of macular hole sizeNRNR
Briand et al. [5]2015Randomized controlled trialSF6: 31
C3F8: 28
Total: 59
SF6: 7 days
C3F8: 14 days
20–25% SF6
15% C3F8
All casesSF6: 93.3%
C3F8: 92.9%
Similar ()SF6: 3.5 lines at 12 months
C3F8: 3.4 lines at 12 months
No significant difference ()
Similar in terms of cataract development and extraction and adverse events
Kumar et al. [13]2014Prospective cohort studySF6: 20
C3F8: 42
Total: 62
SF6: 18 hours daily for 3 days
C3F8: 18 hours daily for 3 days
25% SF6
18% C3F8
All casesSF6: 85%
C3F8: 90.5%
Similar ()NRNR
Xirou et al. [14]2012Prospective cohort studySF6: 23
C3F8: 23
Total: 46
SF6: 2 days
C3F8: 2 days
20% SF6
14% C3F8
All casesSF6: 100%
C3F8: 96%
SimilarSF6: 3.8 lines (0.67 ± 0.20 to 0.29 ± 0.12 logMAR) at 6 months
C3F8: 2.8 lines (0.90 ± 0.10 to 0.62 ± 0.23 logMAR) at 6 months
No significant difference ()
Patients treated with SF6 experienced greater improvement of visual acuity initially but was similar in the following 6 months. Similar elevations of intraocular pressure
Kim et al. [15]2008Retrospective comparative studySF6: 38
C3F8: 41
Total: 79
SF6: 7 days
C3F8: 7 days
20% SF6
16% C3F8
All casesSF6: 90%
C3F8: 91%
Similar (), regardless of stage, duration of symptoms, presence of PVD, and use of ICG dye for ILM peelingSF6: 4.9 lines (0.86 ± 0.41 to 0.37 ± 0.43 logMAR) at 12 months
C3F8: 5.4 lines (0.99 ± 0.43 to 0.45 ± 0.35 logMAR) at 12 months
No significant difference ()
Cataract development was similar. Myopic shift was greater in the C3F8 group ()
Tognetto et al. [7]2006Retrospective cohort studySF6: 1,004
C3F8: 337
Total: 1,627
SF6: NR
C3F8: NR
NR67.7% of casesSF6: 93.6%
C3F8: 87.2%
Higher success rates with SF6NRNR
Mulhern et al. [16]2000Prospective comparative studySF6: 31
C3F8: 31
Total: 62
SF6: 14–30 days
C3F8: 6 days
23% SF6
16% C3F8
Not routinely performedSF6: 96.7%
C3F8: 93.5%
Similar ()SF6: 2.8 lines (0.86 ± 0.18 to 0.575 ± 0.31 logMAR) at 3 months
C3F8: 2.7 lines (0.88 ± 0.21 to 0.61 ± 0.37 logMAR) at 3 months
No significant difference ()
Incidence of posterior subcapsular cataract was similar. Mean IOP spike maximum was nonsignificantly higher in the SF6 group

NR, not reported; C3F8, perfluoropropane; SF6, sulfur hexafluoride; ILM, internal limiting membrane; PVD, posterior vitreous detachment; ICG, indocyanine green; IOP, intraocular pressure. Expressed in Early Treatment Diabetic Retinopathy Study (ETDRS) chart lines.

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