Outcomes of 25-gauge pars plana vitrectomy using silicone oil versus C3F8 gas tamponades in rhegmatogenous retinal detachment

Aims: To compare the visual and anatomical outcomes, intraocular pressure (IOP) changes, and complications of 25-gauge pars plana vitrectomy (PPV) using silicone oil (SO) versus perfluoropropane (C3F8) gas tamponade in the management of rhegmatogenous retinal detachment (RRD). Methods: This retrospective study analyzed 43 eyes of 43 patients treated with 25-gauge PPV for RRD. Patients were divided into two groups: Group 1 (SO, n=25) and Group 2 (C3F8 gas, n=18). Visual acuity, IOP, and postoperative complications were evaluated over a 52-week follow-up period. Statistical comparisons were conducted using the SPSS software, and a significance level of p<0.05. Results: Both groups demonstrated significant improvements in best-corrected visual acuity (BCVA) at the 52nd week. Mean BCVA improved from 2.23 ± 0.89 logMAR to 0.30 ± 0.21 logMAR in the SO group and from 2.07 ± 0.87 logMAR to 0.19 ± 0.05 logMAR in the C3F8 group. Recurrent retinal detachment was observed in 8% of SO cases and 16.7% of C3F8 cases, with successful reattachment achieved in all reoperations. IOP increased mildly in the SO group but decreased significantly in the C3F8 group. Anti-glaucomatous therapy was initiated in 16% of patients in the SO group and 16.7% in the C3F8 group. Conclusion: Both SO and C3F8 gas tamponades are effective in achieving visual and anatomical success following 25-gauge PPV for RRD. C3F8 gas demonstrated better IOP stabilization, whereas SO was effective for more complex cases. These findings support the tailored use of tamponades based on individual patient and disease characteristics.