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Impressum
Unexpected clinical findings in the use of heavy endotamponade
1Roider J., 2Hoerauf H., 1Kobuch K., 1Gabel V.-P.
1Augenklinik der Universität Regensburg, 93051 Regensburg, 2Augenklinik der Universität Lübeck, 23538 Lübeck
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).
Method: 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 reaction and opticus atrophy and
currently are not suited as permanent tamponade