Heavy Tamponade Using F6H8 is Effective in Repairing Complicated Inferior Retinal Detachment but Might Have a Potential Toxic Effect Resulting in Low Visual Acuity

Abstract

Abstract: : Purpose: To report our clinical experience using a hydrofluorocarbon liquid (HFCL) i.e. (F₆H₈) as a temporary tamponade in complicated vitreo-retinal conditions, compared to silicone oil and /or expanding gas. Methods: 15 patients with "hard to manage" retinal detachments were enrolled in a study of 3-4 weeks tamponade with F₆H₈. 15 patients with similar pathology underwent surgery but with silicone oil or gas as tamponade during the same period. Pre and postoperative best corrected visual acuity (BCVA); intraocular pressure (IOP), grade of retinal reattachment; F₆H₈ droplet formation, postop cataract progression and cause of any reoperation were monitored. Material: 15 patients, 8 women 7 men with a mean age 54 years, were included in the F₆H₈ -group. Two giant breaks, one penetrating eye injury, seven PVR (included one with PDRP combined with PVR) and five retinal redetachments in the two lower quadrants were studied. Of 15 patients operated with silicone oil or expanding gas , 9 were women 6 men, mean age 55 years. 8 cases had PVR and 7 had various complicated retinal detachments. Results: Best-corrected visual acuity (BCVA) was measured with Monoyer-Granstrom charts under standardized conditions by a trained ophthalmic nurse and a change was defined as a minimum difference of two or more steps. Noted complications were temporary elevated IOP in two patients, droplets of F₆H₈ entering the anterior chamber in seven patients, progression of cataract in one patient. No patients had subretinal F₆H₈. Conclusions: Using perfluorohexyloctane (F₆H₈₎ as a tenuous 3-week tamponade seems to increase the chance of reattaching the retina in the two lower quadrants. Compared to "standard" tamponade procedures using silicone oil/expanding gas the results are similar concerning anatomic reattachment. However the BCVA measured at last visit are much worse in the F₆H₈ group. One explanation could be that these patients had a more complex pathology reflected in higher amount of reoperations but we can not rule out a toxic effect of F₆H₈ which would negatively influence the final BCVA results.  

Keywords: vitreoretinal surgery • vitreous substitutes • retinal detachment