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J.A. Mackiewicz, K. Maijwee, C. Lüke, W. Hiebl, Y.–K. Kim, H. Meinert, Z. Zagorski, B. Kirchhof, A.M. Joussen; Effect of Gravity in Long–Term Vitreous Tamponade in vivo Investigation Using Perfluorocarbon and Hydrofluorocarbon Liquids . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5445.
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Purpose: Perfluorocarbon liquids (PFCLs) and hydrofluorocarbon liquids (HFCLs) are being increasingly used as soft tools during vitreoretinal surgery. However, since long–term intraocular tolerance is still unsatisfactory, at present complete removal at the end of surgery is recommended. In order to investigate, whether gravity is the reason for retinal degeneration in long–term vitreous tamponade, we compared perfluorohexyloctane (F6H8), perfluorodecalin (PFD) and a mixture of F6H8/Decalin. Methods: Each 5 rabbits received a 3 months tamponade with either PFD (pure) (1,93 g/cm3), F6H8 (pur) (1,33 g/cm3), or a 1:1 mixture of F6H8/PFD (1.62–1,63 g/cm3). ERG testing was performed pre– and postoperatively. Lower and upper retinal areas were compared using HE staining, CD45 immunohistochemistry and TUNEL assay. TEM was performed to investigate alterations in the photoreceptors. Results:All three substances were tolerated well in rabbit eyes for up to 3 months. Emulsification was seen earliest with PFD and latest with pure F6H8. None of the substances demonstrated inflammatory reactions or vascular alterations. ERGs were not considerably altered with either of the substances. Histology of the retina showed alterations in the cell counts within the inner and outer nuclear layer which were not attributable to the gravity of the tamponading agent. Conclusions: In experimental and clinical use, emulsification, vascular changes and structural alterations of the retina have been described. In contrast to previously published work, we were unable to detect a tamponade related structural damage of the retina after a 3 months tamponade in the rabbit model. Based upon this study gravity might not be causally linked to retinal damage.
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