Influence of Tamponade on Retinal Shift in Eyes Undergoing Vitrectomy for Rhegmatogenous Retinal Detachment: A Comparison of Gas Versus Silicone Oil in a Pakistani Population

Rhegmatogenous retinal detachment (RRD) is a vision-threatening condition with an estimated incidence of approximately 1 in 10,000 individuals annually. Pars plana vitrectomy (PPV) combined with intraocular tamponade agents such as expansile gas or silicone oil is a commonly used surgical treatment for retinal reattachment. Although anatomical success rates following PPV are high, postoperative retinal displacement has increasingly been recognized as a frequent phenomenon. Retinal displacement may lead to visual distortion, metamorphopsia, and patient dissatisfaction despite successful anatomical repair. Fundus autofluorescence (FAF) imaging allows detection of retinal vessel printings (RVPs), which appear as hyperautofluorescent lines corresponding to the previous location of retinal vessels. These findings are considered markers of postoperative retinal displacement. Several studies have suggested that the type of intraocular tamponade may influence the occurrence of retinal displacement, with some reports demonstrating higher displacement rates in eyes treated with gas tamponade compared with silicone oil. However, findings remain inconsistent across studies, and limited data exist from South Asian populations. This study aims to evaluate the influence of intraocular tamponade type on postoperative retinal displacement following PPV for primary rhegmatogenous retinal detachment in a Pakistani population. This prospective randomized comparative study was conducted at the Section of Ophthalmology and Visual Sciences, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan. Patients diagnosed with primary rhegmatogenous retinal detachment who were scheduled to undergo pars plana vitrectomy were eligible for inclusion. Participants were randomized to receive either gas tamponade (sulfur hexafluoride \[SF6\] or perfluoropropane \[C3F8\]) or silicone oil tamponade at the end of surgery. Step 1: Define the Arms ARM 1: Gas Tamponade ARM 2: Silicone Oil Tamponade All surgical procedures were performed using a standardized 25-gauge pars plana vitrectomy technique by experienced vitreoretinal surgeons. Standard surgical steps included core vitrectomy, peripheral vitreous shaving with scleral indentation, drainage of subretinal fluid, retinopexy using laser or cryotherapy, and final internal tamponade according to randomized allocation. Baseline demographic and clinical characteristics including age, gender, duration of symptoms, macular status, and presence of proliferative vitreoretinopathy were recorded preoperatively. Postoperative retinal displacement was assessed using fundus autofluorescence imaging at the 1-month follow-up visit. Retinal displacement was defined as the presence of hyperautofluorescent lines corresponding to retinal vessel printings on FAF images. The primary outcome of the study is the incidence of postoperative retinal displacement at 1 month after surgery. Secondary analyses evaluate the relationship between retinal displacement and factors such as patient age and duration of retinal detachment prior to surgery. Understanding the relationship between tamponade type and postoperative retinal displacement may help improve surgical planning and patient counseling regarding visual outcomes following retinal detachment repair.

NCT Number	NCT07495319
Lead Sponsor	Wardah
Conditions	Retinal Detachment Rhegmatogenous, Vitrectomy, Retina Disorder
Enrollment	78 participants
Start Date	2025-04-15
Primary Completion	2025-12-31 (estimated)
Study Completion	2026-01-31 (estimated)
Updated on ClinicalTrials.gov	2026-03-31