Abstract
Abstract: :
Purpose: Heavy tamponades for pathologies in the lower part of the retina are a new development and different tamponades recently are in clinical use: semifluorinated alcanes (F6H6, F6H8) and their oligomeres (OL62HV). Methods:As worst case selection 9 patients had been operated by F6H8 (n=5) and by OL62HV (n=4) In all cases the reason for use of the tamponades were complicated retinal detachment in the lower part, in 3 cases the use was primary and in 3 cases after reoperations. In all cases the endotamponade was removed within 6 weeks. Fluorescein angiography was performed in the F6H8 group. Results:In the F6H8 group emulsification developed in 2/3 aphakic patients. In 1/5 patients the substances became opac on the surface and in 2/5 cases soft epiretinal membranes and cellular material could be found between the substance and the lower periphery. In 2 membranes examined by light microscopy macrophages and amorphous material could be found. In one case (PDRP, aphak) cycclophotocoagulation had to be performed because of persistent elevated IOP. FLA was unremarkable. In the oligomer group (OL62HV) severe recurrent PVR reaction occurred in the lower periphery (2/4) and unusal precipates (3/4). In one case after a normal postoperative period (VA 0.05 after 5 days) an extensive cellular reaction on the complete surface (OL62HV / lens and OL62HV / retina) occurred. After 5 weeks VA was defect in light perception. During removal of the oligomer unusual adherent cellular components on the surface of the retina, which appeared fragile, narrowed retinal vessels and an optic atrophy could be found. Conclusion:: Heavy endotamponades on the basis of semi fluorinated alcanes can lead to unusual biological reactions. Further animal experiments are warrented to explain theses effects.
Keywords: 630 vitreous substitutes • 628 vitreoretinal surgery • 563 retinal detachment