Experimental Studies on the Retinal Responses to Subretinal Perfluorocarbon Liquids

ABSTRACT

Perfluorocarbon liquids are frequently used intraoperatively in repair of complicated retinal detachments. One complication of their use is prfluorocarbon liquids entering the subretinal space via a retinal break or an iatrogenic retmotomy since these liquids are much heavier than water, We evaluated the response to subretinal perfluorophenanthrene (VitreonR) on the rabbit retina ophthalmoscopically and microscopically. Twenty eight rabbit eyes underwent subretinal injection of 50-100 ml of perfluorophenanthrene via the vitreous space. The same volume of balanced salt solution was injected into control eyes. Eyes were monitored by indirect ophthalmoscopy and examined by light and electron microscopy. Progressive retinal detachments with newly formed retinal breaks in the inferior quadrants developed in 24 of 28 eyes. In the remaining 4 eyes, small retinal bleb, from 0.5 to 3DD size, occurred in inferior peripheral retina. The photoreceptor outer and inner segments were lost and receptor cell nuclei began to deplete within 1-3 days. In addition, marked vacuole formation in the retinal fiber layers as well as in inner and outer nuclear layers were seen. The photoreceptor outer and inner segments had a1most dlsappeared and the number of nuclei in irulei and outer nuclear layers was markedly decreased from 1 to 3 months. The control eyes reattached and healed spontaneously within 3-5 days. Our findings suggest that all subretinal perfluorophenanthrene should be carefully removed from the eyes at the end of the surgery.