Survey of the use of long-lasting expanding gases in ophthalmology in Japan

PURPOSE: To survey the use of long-lasting expanding gases in ophthalmology in Japan. SUBJECTS AND METHODS: A questionnaire was sent to 1,236 teaching hospitals approved by the Japanese Ophthalmological Society requesting information regarding indications, methods, efficacy and complications related to the use of long-lasting expanding gases administered from January through December 2005. RESULTS: Four-hundred and fifty-nine hospitals responded to the survey (response rate 37.1%). A total of 174,221 ophthalmic surgeries were performed during the survey period, with long-lasting expanding gases used in 19,816 of cases (11.4%). The surgical procedure was vitrectomy in 89.6% of cases in which gas was administered. The most frequent indication for gas use was rhegmatogenous retinal detachment, for which SF6 was the preferred gas. Industrial use gas was utilized in 76.1% of cases, while 22.4% of cases received medical use gas. Increase in intraocular pressure was the most common complication of intraocular gas tamponade (3121 cases, 15.7%), followed by cataract formation. Ninety-eight percent of ophthalmologists responding supported the use of long-lasting expanding gases with vitrectomy, 85% with scleral buckling procedures, and 84% with surgery to remove subretinal hemorrhage. The consensus was that substantial deterioration of surgical results would occur if long-lasting expanding gases could not be used. CONCLUSIONS: Long-lasting expanding gases are being widely administered in ophthalmology in Japan, and appear to have good efficacy for a variety of indications. Several complications related to the use of these gases were reported, however the rates of complications were low.