Exchange of perfluorodecalin for gas or oil: a model for avoiding slippage.

Abstract

The introduction of liquid perfluorocarbons as an intraoperative tool has greatly facilitated retinal re-apposition in giant retinal tears (GRT) and relieving retinotomies (RR). Slippage of the retina can occur during the exchange of heavy liquids for oil or gas, especially if the fill of perfluorocarbons is subtotal. We have used a model eye chamber to study the surface interactions of perfluorodecalin (PFD) with silicone oil and air to evaluate possible mechanisms of slippage. The results demonstrate that it is possible during a PFD/air exchange to trap a wedge of aqueous which is displaced laterally and forced posteriorly during removal of the PFD, whereas during a PFD/silicone oil exchange the remaining aqueous is displaced laterally and upwards and thus trapped above the silicone oil/PFD interface. We believe that during PFD/air exchange the displacement of the aqueous posteriorly can cause slippage and that this could be avoided by performing a direct PFD/silicone oil exchange.