Perfluoro-n-octane Research Articles

PERFLUOROCARBON LIQUIDS' ABILITY TO PROTECT THE MACULA FROM INTRAOCULAR DROPPING OF METALLIC FOREIGN BODIES

To examine the utility of perfluoro-n-octane (PFO) in balanced salt solution (BSS) to shield the macula from the impact of dropped metallic intraocular foreign bodies (IOFBs) by modeling scenarios in which they may fall during surgical removal. Model eyes were filled with various fluid mixtures (Group 1: 10% PFO/90% BSS; Group 2: 100% BSS; Group 3: 100% PFO; Group 4: 10% PFO/90% air; Group 5: 10% BSS/90% air). In Groups 1, 4, and 5, the 10% fluid volume covered the theoretical macula. For each fluid mixture, up to 30 IOFB drop scenarios were performed for each of the 5 sample IOFBs from 3 locations. Trajectories were recorded using a camera attached to a Zeiss operating microscope (Carl Zeiss, Jena, Germany). The percentages of IOFBs impacting the macula were calculated and Fisher exact test was used to assess differences. In Group 1, 93% (417/450) of the dropped IOFBs were deflected by the PFO-BSS interface compared with 0% (0/500) in Groups 2, 3, 4, and 5 (P < 0.01). With the exception of the heaviest IOFB (24.4 mg), which impacted the macula in 30% of tests when dropped from the superior posterior segment (P < 0.01), all other IOFBs (2.8-13.4 mg) were deflected by the PFO-BSS interface in 100% of Group 1 drops (P < 0.01). As demonstrated by these simulations, the PFO-BSS interface can deflect IOFBs dropped during surgery in a wide range of scenarios, especially when the IOFB is of lower mass.

Postoperative Perfluro-N-Octane tamponade for complex retinal detachment surgery

To study outcomes after using perfluoro-n-octane (PFO) as a short-term postoperative vitreous substitute in eyes undergoing primary vitrectomy with or without sclera buckling for complex rhegmatogenous retinal detachments with inferior/multiple breaks or giant retinal tears (GRTs) or retinal detachment with extensive proliferative vitreoretinopathy (PVR). A prospective study was carried out where in 43 patients (Group 1) PFO was exchanged with silicon oil in the same surgical procedure and in 22 patients (Group 2) PFO was kept for 3 days and then exchanged with silicon oil by a separate surgical procedure. The respective surgeon took the decision whether to exchange PFO on the same day or after 3 days. The patients were followed up for 6 months to analyze the anatomical attachment rates, visual acuity gain, and postoperative complications in both the groups. There were 33 male and 10 female patients in group 1 and 18 male and 4 female patients in group 2. Mean age distribution in group 1 was 38.88 years (SD ± 21.45) and in group 2 was 38.09 years (SD ± 16.36). Mean preoperative best corrected visual acuity in group 1 was 2.02 ± 0.58 and in group 2 was 2.01 ± 0.53 logarithm of the minimum angle of resolution (LogMAR). The LogMAR Visual acuity in group 1 improved to 1.76 ± 0.43 after 1 month (P = 0.01, paired t test) and to 1.62 ± 0.62 after 6 months (P = 0.01, paired T test). This visual acuity in group 2 improved to 1.85 ± 0.42 after 1 month (P = 0.24, paired T test) and 1.90 ± 0.72 after 6 months (P = 0.49, paired T test). There was no difference regarding visual improvement in between two groups after 1 month and 6 months of follow-up (P = 0.125, independent sample T test). The retina was detached in 6 patients (14%) in group 1 and in 7 patients (31%) in group 2 after 6 months of follow-up. There was no statistically significant difference in between two groups regarding final attachment of retina (P = 0.109, Fisher exact test). There was also no significant complication. like increased posterior capsular opacification or glaucoma found after retaining PFO for 3 days. Conclusion: Perfluoro-n-octane is efficacious and safe as a short-term vitreous substitute in primary rhegmatogenous retinal detachment repair cases with inferior/multiple breaks or GRTs or with extensive PVR. But keeping perfluoro-n-octane for 3 days does not significantly reduce the risk of re-detachment with complex rhegmatogenous retinal detachment cases.

Perfluoro-n-octane as a temporary intraocular tamponade in a staged approach to manage complex retinal detachments.

PurposeTo evaluate outcomes in patients with complex retinal detachments (RD) with proliferative vitreoretinopathy (PVR) requiring retinectomy using a staged approach utilizing perfluoro-n-octane (PFO) as a short-term postoperative intraocular tamponade.MethodsRetrospective analysis. Patients who underwent 23G pars plana vitrectomy for the management of complicated RD where PFO was used as a primary temporary intraocular tamponade. Only eyes with PVR in rhegmatogenous RD or eyes with penetrating injuries or globe ruptures (ocular trauma) and subsequent RD with PVR were included. Analysis of 17 eyes of 17 consecutive patients with a minimum follow-up of 12 months during a period of 5 years. The primary outcome measure was the reattachment rate after at least 12 months of follow-up after the PFO removal. Secondary outcome measures were changes in visual acuity, complications due to PFO use, and necessity for further surgeries.ResultsEight eyes with prior penetrating injuries or globe rupture and nine eyes with rhegmatogenous pathology were included. All eyes had PFO as temporary tamponade for 14 days (median), which was replaced by silicon oil. Sixteen eyes (94%) had complete and one eye partial reattachment. No redetachments occurred. All eyes retained or improved visual acuity. On average, only 2.5 procedures, including silicon oil removal, were performed. Two eyes had long-term intraocular pressure of 5 mmHg and no eye had intraocular pressure of ≥21 mmHg. No long-term inflammation was observed.ConclusionPFO seems to be beneficial in a staged approach to repair complex detachments when used as short-term tamponade. A median period of 14 days allowed for both sufficient retinal support plus a reduction in side effects seen in long-term endotamponades.

Anatomic and Visual Outcomes of 23-G Vitrectomy without Scleral Buckling for Primary Rhegmatogenous Retinal Detachment

To evaluate the anatomic success rate, visual acuity (VA) changes, and complications of 23-G vitrectomy without associated scleral procedures for the treatment of primary rhegmatogenous retinal detachment (PRRD). Patients diagnosed with PRRD were considered for inclusion. Patients with evidence of proliferative vitreoretinopathy or coexisting ocular pathologies were excluded. Surgery consisted of 23-G vitrectomy with endolaser photocoagulation of retinal breaks and fluid-air-gas (12% C3F8) exchange. Minimum follow-up was 3 months. A total of 133 eyes of 118 patients were included. Fifty eyes were phakic and 83 pseudophakic. Mean time from diagnosis to surgery was 6.9 days (range 1-40). Mean VA improved significantly from 20/50 (range: hand movements to 20/20) to 20/30 (range: counting fingers to 20/16), with no statistically significant differences between phakic and pseudophakic eyes (p = 0.233). Visual acuity improved to 20/40 or better in 104 eyes (78.2%). A redetachment developed in 5 eyes (3.8%), so the primary anatomic success rate was 96.2%. Four eyes required a second surgical procedure and one eye a third to achieve retinal reattachment. Cataract progression in phakic eyes made cataract surgery necessary within 1 year of vitrectomy in 12/50 (24%) eyes. Subretinal perfluoro-N-octane (PFO) was detected in 6 eyes (4.5%). Twenty-three--gauge vitrectomy without scleral buckling seems to be an effective technique for the treatment of PRRD without proliferative vitreoretinopathy. The high anatomic success rate was comparable to that previously described with 20 G and scleral buckling. Complications were similar to those described for 20-G vitrectomy, except for retained subretinal PFO, which has a higher rate.

Twenty-Three-Gauge Pars Plana Vitrectomy With Inferior Retinectomy and Postoperative Perfluoro-n-Octane Retention for Retinal Detachment Repair.

The objective of this article was to study outcomes following use of perfluoro-n-octane (PFO) as a short-term postoperative vitreous substitute in patients undergoing pars plana vitrectomy for a recurrent rhegmatogenous retinal detachment (RRD) with advanced proliferative vitreoretinopathy requiring an inferior retinectomy. A retrospective consecutive chart review. The charts of subjects who underwent RRD repair by pars plana vitrectomy with short-term postoperative PFO, vitreous substitution were retrospectively reviewed. The primary outcome was the anatomic success rate following retinectomy and short-term PFO retention. The secondary outcomes were change in best corrected visual acuity (BCVA) and occurrence of complications related to short-term PFO retention. The anatomic success rate at the final follow-up was 91.7% (11/12). A total of 7 (58.3%; confidence interval, 32%-80.7%) of 12 patients achieved a final BCVA better than initial BCVA. There were no significant complications related to short-term PFO retention. Perfluoro-n-octane is efficacious and safe as a short-term vitreous substitute for repair of a recurrent RRD with advanced proliferative vitreoretinopathy requiring an inferior retinectomy.

POSTOPERATIVE PERFLUORO-N-OCTANE TAMPONADE FOR PRIMARY RETINAL DETACHMENT REPAIR

To study outcomes after using perfluoro-n-octane (PFO) as a short-term postoperative vitreous substitute in eyes undergoing primary vitrectomy with or without scleral buckling for rhegmatogenous retinal detachments with inferior/multiple breaks or giant retinal tears (GRTs). Charts of 39 eyes at 3-24 months after primary PFO retention and secondary replacement were retrospectively analyzed for anatomical attachment rates, visual acuity gain, and postoperative complications. Intraoperatively, 33 of 39 eyes showed ≥ 4 retinal breaks, with 31 of 39 eyes having at least 1 inferior break, 10 of 39 eyes having GRT, and 12 of 39 eyes showing preoperative proliferative vitreoretinopathy. All eyes showed complete anatomical retinal attachment after primary vitrectomy for at least 7-17 days when PFO was retained without any specific posturing. With sulfur hexafluoride (SF6) gas PFO exchange, 3 cases redetached. With perfluoropropane (C3F8) gas or silicone oil PFO exchange, no cases redetached, resulting in a final anatomical success rate of 92.4%. Visual acuity improved from 2.07 ± 0.86 to 0.76 ± 0.79 logarithm of the minimum angle of resolution (P < 0.0004) among macula-off and from 0.11 ± 0.08 to 0.12 ± 0.09 logarithm of the minimum angle of resolution (P > 0.05) among macula-on rhegmatogenous retinal detachment eyes. Perfluoro-n-octane retention ≥ 10 days significantly increased posterior capsular opacification (28 of 39 eyes) and cataract extraction rates (21 of 25 eyes) without affecting the final retinal attachment success rate. Perfluoro-n-octane is efficacious and safe as a short-term vitreous substitute in primary rhegmatogenous retinal detachment repair cases with inferior/multiple breaks or GRTs. Perfluoro-n-octane removal within 10 days reduces its side effect profile considerably. The highest anatomical retinal reattachment rates were observed when C3F8 or silicone oil was exchanged for PFO.

Interaction Between Perfluorcarbon Liquid and Heavy Silicone Oil: Risk Factor for “Sticky Oil” Formation

Purpose: To investigate in vitro the interaction between perfluorcarbon liquids (PFCLs) and heavy silicone oils (HSOs).Methods: Interactions between different kinds of PFCL [perfluoro-n-octane (PFO) or perfluorodecaline (PFD)] and HSO (either alkane or ether) were studied in vitro by incubating fluids for 7 days at regulated temperatures. The samples were divided into two groups: Group A, PFCL (PFO or PFD) + 5 ml of HSO (silicone oil + alkane or ether) and Group B, HSO (silicone oil + alkane or ether) without PFCL. Each sample was kept at 36°C for 7 days. HSOs were then removed with a 20 g, 7 mm-long cannula under 600 mm Hg of vacuum pressure at two different temperatures: 36 and 22°C. The time needed to remove the oils and the presence of opacity was recorded. Each experiment was repeated three times.Results: In vitro, interactions between PFCL and HSO oil led to the formation of hyper-viscous solutions with significative increase in aspiration time in Group A. (P = 0.006, Kruskal–Wallis test) Temperature was also found to affect HSOs’ saturation, as a decrease in temperature determined an increase in opacity and shear viscosity of the solution (P = 0.02, Kruskal–Wallis test). No differences between alkane and ether (P = 0.74) and n-octane and decaline (P = 0.56) was found.Conclusion: Interactions between PFCL–HSO and variation in temperature lead to the formation of hyper-viscous solutions that could be described as “sticky oil”.

Outcome of retinal reattachment surgery in dogs: a retrospective study of 145 cases

To summarize the clinical outcomes and complications of pars plana vitrectomy with perfluoro-n-octane (PFO)-silicone oil exchange and endolaser retinopexy for treatment of retinal detachment (RD) in dogs, at one surgical center. Records of 145 dogs (168 eyes) that underwent retinal reattachment surgery (RR) between 2005 and 2009 were reviewed. All surgeries were performed by the same surgeon (SS). Data collected from the medical records included signalment, duration of time from diagnosis of RD to surgical intervention, if prior lensectomy was performed, time from surgery to restoration of vision, and postoperative complications. The data was analyzed to test the effect of breed, prior lensectomy, and time from diagnosis to surgery on visual outcome, tendency for complications, and time of complication onset. One hundred thirty pure-bred dogs (36 breeds) and 15 mixed-breed dogs were represented. One hundred fifty-five of 168 eyes (92%) were visual after surgery. Six of 155 eyes (3.8%) were visual before the procedure and retained vision; one hundred forty-nine of 155 eyes (96%) were nonvisual before and regained vision afterward. Thirteen of 168 eyes (8%) that were nonvisual prior to the procedure did not regain vision. The most common complications in order of occurrence included: cataract development, silicone prolapse into the anterior chamber, corneal ulceration, retinal degeneration, glaucoma, and uveitis. Pars plana vitrectomy with PFO-silicone oil exchange and endolaser retinopexy for treatment of RD in dogs is highly successful and associated with overall good visual outcome.

Extended Endotamponade with Perfluoro-n-Octane in Pediatric Retinal Detachment.

The use of perfluoro-n-octane (PFnO) for extended endotamponade in an infant with X-linked retinoschisis and complex tractional retinal detachments associated with proliferative vitreoretinopathy (PVR) was reported. The patient had undergone multiple vitrectomy surgeries with silicone oil tamponade. After extensive retinectomy, slippage of the retina produced folds that were flattened under extended PFnO tamponade. The retinas of both eyes remained anatomically reattached 11 months after exchange of PFnO for silicone oil.

Midlenticular Optic Opacification af a Hydrophobic Acrylic Intraocular Lens in Association with Retained Perfluorocarbon Liquid Following Vitreoretinal Surgery.

The postoperative course of a patient who underwent retinal detachment repair using perfluoro-n-octane (PFO) and perfluoropropane (C(3)F(8)) gas endotamponade is described in which midlenticular optic opacification of a hydrophobic acrylic intraocular lens was noted. Mechanisms for optic opacification are proposed, which include dystrophic calcification and PFO-induced optic degeneration. The case presents a novel case of midlenticular intraocular lens optic opacification in the setting of retained perfluorocarbon liquid following retinal detachment repair.

Perfluorocarbon liquid utilization in primary vitrectomy repair of retinal detachment with multiple breaks.

To evaluate the efficacy of pars plana vitrectomy in conjunction with intraoperative perfluoro-n-octane (PFO) use as initial treatment of retinal detachment (RD) with multiple breaks located at various distances from the ora serrata. Twenty-two consecutive eyes (15 phakic, 2 aphakic, and 5 pseudophakic) presenting with RD with multiple breaks and tears underwent primary pars plana vitrectomy, PFO retinal reattachment, transcleral cryopexy or endolaser treatment of breaks, PFO/air exchange, and final injection of 18% perfluoropropane (C3F8). Scleral buckles were not used. The mean follow-up period was 29 months. Temporary PFO utilization attached the posterior retina and facilitated the safe removal of vitreous at its base and around the retinal tears. Intraoperative complications included new breaks (3 eyes), enlargement of breaks (2 eyes), and a small bubble of subretinal PFO (1 eye). Postoperatively, the retina remained attached during follow-up in 19 eyes. Cataract developed or progressed in 13 phakic eyes. Pars plana vitrectomy in conjunction with intraoperative PFO utilization is effective as initial treatment of RDs with multiple breaks. The main limitation of this technique is the postoperative progressive cataract formation in phakic eyes.

Interactions of perfluorocarbon liquids and silicone oil as characterized by mass spectrometry.

Perfluorocarbon liquids (PFCL) are used extensively in complex vitreoretinal surgery, sometimes before the placement of silicone oil (SiO). We suspected that PFCL and SiO interact physically when in opposition, potentially making their removal more difficult. The nature of some of these interactions was explored using a mass spectrometric approach in in-vitro and in-vivo samples. We incubated silicone oil (1,000 or 5,000 centistokes viscosity) and PFCL [perfluoro-n-octane (PFO) or perfluorotributylamine] together in vitro for 6 months and performed electron impact ionization mass spectrometry (EIMS) on the PFCL to characterize interactions between the liquid phases. Packaged samples of PFCL served as controls. We also examined in vivo samples of PFO which had been retained in human eyes for several months prior to surgical removal. Perfluorocarbon liquids packaged for surgical use all contain SiO in trace amounts, possibly as a manifestation of the processes used in their manufacture. Furthermore, all PFCLs incubated with SiO showed much more prominent contamination with SiO molecular fragments. PFCL was found in the SiO phase of eyes in which both liquids were present for extended periods of time. The EIMS analysis of in vivo samples suggested that proteins coat PFCL droplets, forming micelle-like structures. Medical-grade PFCLs contain small amounts of SiO, and PFCLs dissolve small amounts of oil into solution over time. Interactions between retained vitreous substitutes may have clinical relevance.

Outcomes of surgery for retinal detachment associated with proliferative vitreoretinopathy using perfluoro-n-octane: a multicenter study

Purpose To report visual acuity and anatomical outcomes, as well as complications, of management of complex retinal detachment with proliferative vitreoretinopathy using pars plana vitrectomy and intraoperative perfluoro-n-octane (PFO), and to investigate clinical features associated with anatomical and visual acuity outcomes. Design Prospective, noncomparative, interventional multicenter study. Methods The study included 555 patients (555 eyes) 15 months of age or older who underwent pars plana vitrectomy for complex retinal detachment associated with proliferative vitreoretinopathy with intraoperative PFO at 24 study sites between April 1994 and February 1996. Main outcome measures included visual acuity and rates of retinal reattachment, reoperation, retained PFO, corneal edema, elevated intraocular pressure ([IOP] > 25 mm Hg), hypotony (IOP < 5 mm Hg), and cataract. All outcome measures were assessed at 1 day, 1 week, 1 month, 3 months, and 6 months postoperatively and at the last examination. Results The study included 555 eyes of 555 patients followed up at a median of 5.6 months. Visual acuity of 20/200 or better was recorded in 51 (10%) patients preoperatively and 85 (24%) at 6 months postoperatively. Among the 465 eyes with both preoperative and final visual acuities available, postoperative visual acuity improved in 274 (60%) eyes, remained stable in 106 (23%), and worsened in 85 (18%) eyes. Six-month follow-up data were obtained for 356 (65%) eyes; the retina was attached in 279 (78%) eyes and retained PFO was noted in 20 (6%). Throughout follow-up, 238 of 555 (43%) eyes underwent reoperation for recurrent retinal detachment. At 6 months, corneal edema, elevated IOP, and hypotony were noted in 26 of 356 (7%), 6 of 356 (2%), and 48 of 356 (15%) eyes, respectively. Of the 114 phakic eyes without significant cataract preoperatively, 105 (92%) developed a significant cataract or underwent cataract surgery during study follow-up. Operative factors significantly ( P < .05) associated with recurrent retinal detachment include female gender, creation of a relaxing retinotomy, and the use of sulfur hexafluoride (SF 6) gas tamponade, air tamponade, or no tamponade (compared with perfluoropropane [C 3F 8] or silicone oil tamponade). Factors significantly associated with final vision of 20/200 or better include first operation anatomic success, prior scleral buckling procedure, no diabetes mellitus, no prior vitrectomy, no silicone oil retinal tamponade, and no relaxing retinotomy. Cases that require relaxing retinotomy generally represent more severe cases of complex retinal detachment and, therefore, relaxing retinotomy is likely associated with a poorer visual outcome owing to the nature of the cases selected for this procedure. Conclusions In the management of complex retinal detachment associated with proliferative vitreoretinopathy, pars plana vitrectomy and use of intraoperative PFO was associated with retinal reattachment and preserved visual acuity in most eyes.

Clinicopathologic findings in eyes with retained perfluoro- n-octane liquid

Objective To describe the clinical and histopathologic findings in five eyes with retained perfluoro- n-octane (PFO) liquid after retinal reattachment surgery. Design Retrospective, noncomparative, clinicopathologic case series. Participants Surgical specimens from five eyes were studied. Methods Surgical specimens from eyes with prior intraoperative PFO use submitted to the W. Richard Green Eye Pathology Laboratory at the Wilmer Ophthalmological Institute were identified and reviewed. Main outcome measures Histopathologic analysis and energy dispersive spectroscopy identified intracellular vacuoles containing PFO. Results Five cases were identified. Three specimens were obtained at the time of further surgery for recurrent retinal detachment; one at repeat penetrating keratoplasty, and one at removal of retained PFO. Each eye had macroscopic white flake-like material on intraocular structures noted before or during surgery. Histopathologic analysis disclosed an inflammatory response featuring macrophages with intracellular vacuoles containing PFO. Removal of the PFO in all five eyes combined with repeat retinal reattachment surgery in three eyes resulted in resolution of the inflammatory response. Conclusions Retention of PFO after surgery elicits an inflammatory response. We suspect that young patients, those with considerable residual vitreous gel, and eyes with larger amounts of retained PFO may be at higher risk for this complication.

Perfluoroperhydrophenanthrene versus perfluoro- n-octane in vitreoretinal surgery

Purpose To compare two perfluorocarbon liquids, perfluoroperhydrophenanthrene (Vitreon) and perfluoro- n-octane (PFO), regarding (1) ease of removal at the time of surgery and (2) efficacy and safety. Design Retrospective, nonrandomized, comparative trial. Participants Two hundred sixty-four patients. Methods All medical records of patients who participated in either the Vitreon (n = 142) or the PFO (n = 122) multicenter trials at the Wilmer Eye Institute were reviewed. Patients in the two groups were compared with respect to presence and amount of postoperative perfluorocarbon. Safety and efficacy of the two perfluorocarbon liquids were evaluated in the subset of patients undergoing surgery for retinal detachment with PVR grade C or more, who had at least 6 months of postoperative follow-up (n = 46 in the Vitreon group and n = 55 in the PFO group). Best-corrected visual acuity, intraocular pressure, and status of the cornea, lens, and retina after 3, 6, and 12 months of follow-up were compared in the two groups. Main outcome measures Percentage of eyes with retained perfluorocarbon, final visual acuity, final retinal attachment rate. Results At the 6-month postoperative visit, retained Vitreon or PFO was detected in 8.4% and 4% of the eyes, respectively ( P < 0.05). No statistically significant difference was found between the two perfluorocarbons in attachment rate or visual acuity after 6 and 12 months. After 6 months, the retina was attached in 71.7% of the eyes in which Vitreon was used and in 78.3% of the eyes in which PFO was used ( P = 0.81). Visual acuity improved or remained stable in 80% of the Vitreon group eyes and in 74.5% of the PFO group eyes ( P = 0.75). No statistically significant difference was found in final visual acuity or intraocular pressure between the two groups after 6 or 12 months. There was a tendency at the 12-month follow-up examination for the cornea to remain clearer in the Vitreon group ( P = 0.01). Conclusions Although PFO was easier to visualize and remove completely from within the eye at the time of surgery, the efficacy in terms of retinal attachment and final visual outcome was similar between the Vitreon and PFO groups.

Perfluoro-N-Octane (PFO) in the Repair of Complicated Retinal Detachments Due to Severe Proliferative Diabetic Retinopathy

To report our experience with perfluoro-N-octane (PFO) in the surgical management of complicated retinal detachments due to proliferative diabetic retinopathy. Retrospective review of 18 consecutive eyes of 18 patients with tractional or combined tractional and rhegmatogenous retinal detachments due to severe proliferative diabetic retinopathy managed by pars plana vitrectomy and the intraoperative use of PFO. Preoperative characteristics, intraoperative findings and procedures and postoperative results were recorded. The mean preoperative acuity was 2/200 (range, 20/25 to light perception). The mean final visual acuity was 4/200 (range, 20/20 to no light perception). With a mean follow-up of 6 months, there was an 89% anatomic reattachment rate at the last visit and visual acuity was stable or improved in 72% of eyes. In our experience, PFO is a helpful surgical adjunct in the anatomic reattachment of tractional or combined tractional and rhegmatogenous diabetic retinal detachments. Visual acuity was stabilized or improved in the majority of eyes.

EXPERIMENTAL STUDIES OF TOLERANCE TO INTRAVITREAL PERFLUORO-N-OCTANE LIQUID

Low viscosity perfluorocarbon liquids are useful adjuncts during vitreoretinal surgery. This study evaluates perfluoro-n-octane (PFnO) for intraoperative use by examining ocular tolerance in rabbits and pigs. Rabbits were treated with intravitreal placement of PFnO for 48 hours and were examined during a period of 2 months following treatment. No clinical, electroretinographic, or light and electron microscopic evidence of adverse effects on the retina were observed. Small residual amounts of PFnO produced no adverse histologic changes 6 months after treatment. In pigs treated with mechanical vitrectomy and placement of PFnO for 3 hours, electron microscopic evaluation of the retina confirmed that the liquid had been well tolerated. These findings indicate that PFnO is safe for intraoperative use. When PFnO remained in the vitreous cavity of rabbits for longer than 1 week, varying degrees of globule dispersion occurred. Furthermore, histologic examination revealed changes in the inferior retina: photoreceptor outer segments were distorted, the outer plexiform layer was narrowed, and preretinal accumulation of macrophages had occurred.