Schäfer H. G., Gümbel H. O. C.

Bundeswehrkrankenhaus, Ophthalmic Department, Oberer Eselsberg 40, D-89081 Ulm, Germany

Objective: To demonstrate by means of a case report possible effects of perfluorohexyloctane having entered into the anterior chamber.
Methods: Vitrectomy via pars plana together with irrigation and aspiration were used as surgical techniques to remove perfluorohexyloctane from the vitreous and the anterior chamber, respectively. Ophthalmic examinations including visual acuity, tonometry as well as examining the anterior and posterior segments of the eye were performed, photographs were taken in addition.
Results: Before surgery the vitreous was filled almost totally whereas slightly more than half the volume of the anterior chamber was occupied with perfluorohexyloctane which had formed multiple bubbles there. Despite regular findings in the anterior segments of the eye except for a cataractous lens the intraocular pressure was elevated up to 32 mmHg. After the operation had been performed it fell to 5 mmHg. With a clear cornea the visual acuity remained unchanged at 20/100 because of a macular hole. Several days after surgery a distinct level of perfluorohexyloctane reappeared.
Conclusions: Even with regular anterior eye segments perfluorohexyloctane may flood the anterior chamber. Because of its propensity to disperse a consequent secondary glaucoma may occur. In case perfluorohexyloctane remains in the anterior chamber for only few weeks toxic effects do not necessarily have to show up. Reappearing distinct levels of perfluorohexyloctane may be explained by its more lipophilic nature compared to different perfluorocarbon liquids.

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