Purchase this article with an account.
A. M. Joussen, J. Mackiewicz, W. Hiebl, H. Meinert, N. Kociok, B. Kirchhof; Pneumatic Retinopexy by Evaporation of Perfluorcarbon Liquids. In vitro and in vivo Results. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5718.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To develop a new expandable gas tamponade that allows a slow complete filling of the vitreous cavity.Materials and
Twenty five different liquid perfluorocarbon admixtures with gas were tested both in a model and and in vivo in rabbit eyes. The model eye was filled with 4.3 - 4.5 ml purified water and 20 - 40 µl of the respective gas component were injected with subsequent heating to 37 °C in water bath. Expansion of the gas mixture was observed for minimum 3 hours. For the in vivo experiments, 20 µl of each substance was injected 1.5mm posterior to the limbus into the midvitreous using a microliter syringe in n = 5 eyes per group. The eyes were monitored every hour for 4 h, then every 4 hours for 2 - 3 days, then twice daily for one week, daily for the next week. The intraocular pressure, the anterior segment of the eye, vitreous and retina were inspected at each examination. The time of maximum expansion and the period until complete absorption of the gas bubble were recorded.
No expansion in the glass eye was observed when the hydrostatic pressure was too high, a rapid expansion (explosion) in substances with high vapour pressure. Several mixtures of perfluorocarbons (PFCL) and semifluorinated alkanes (SFA) with ether/alkanes resulted in limited temporary gas expansion in vitro, associated a large increase in "IOP". Mixtures of pentane in paraffin oil or silicone oil resulted in a complete gas filling remaining for several days with acceptable intraocular pressures. In vivo, different clinical pictures and amounts of gas expansion were observed after the injection of liquid perfluorocarbon mixtures with gas, ranging from no expansion to positive reactions resulting in different levels of expansion. Normal intraocular pressure was maintained in these eyes, but only transient incomplete filling of the vitreous cavity with gas. A very rapid gas expansion associated with a rapid raise in intraocular pressure, shallow anterior chamber and finally rupture of the globe was observed other cases, even in substances that were positively evaluated in an in vitro eye model. There was only limited correlation between the in vivo and in vitro data.
The study underscores the feasibility of endotamponade based on vaporization of liquid perfluorocarbons. Still a more detailed investigation on the factors influencing vaporization in vivo is required.
This PDF is available to Subscribers Only