Comparison of autologous platelet-rich plasma injection with air tamponade versus C3F8 tamponade in idiopathic full-thickness macular hole surgery

Abstract

Vitrectomy, combined with internal limiting membrane peeling and gas tamponade, is the gold standard for treating full-thickness macular holes (FTMH). However, prolonged intraocular tamponade duration often causes patient discomfort and delays visual recovery, necessitating the need for alternative approaches. Autologous platelet-rich plasma (APRP) injection, an adjunctive therapy, improves macular hole closure. This study compared surgical outcomes using APRP injection with air tamponade (APRP + Air group) versus the conventional perfluoropropane (C 3 F 8 ) gas tamponade (Gas group). We retrospectively analyzed 61 eyes from 61 patients diagnosed with idiopathic FTMH (base diameter < 1300 μm), grouped based on patient treatment choice (APRP + Air group, n = 23; Gas group, n = 38). The hole closure rate, best-corrected visual acuity (BCVA), optical coherence tomography findings and tamponade duration were analyzed at baseline and 1, 3 months after surgery in both groups. Hole closure rate did not differ significantly between groups during follow-up (APRP + Air group: 100%, Gas group: 97.4%). Postoperative BCVA and OCT findings did not differ significantly between groups. The mean tamponade duration was significantly shorter in the APRP + Air group (7.09 ± 1.16 days) than the Gas group (28.84 ± 4.15 days; p < 0.001). Macular hole surgery using APRP + Air tamponade demonstrated favorable short-term results in anatomical closure rates and BCVA, with no statistically significant difference compared to C 3 F 8 tamponade, while offering the advantage of a significantly shorter postoperative tamponade duration. Therefore, this procedure may provide a suitable option for patients with idiopathic full-thickness macular holes who want to reduce discomfort and achieve quicker postoperative recovery.