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Impressum
Ocular perfluorohexyloctane endotamponade for treatment of persisting macular hole
Weiler S., Jäger M., Jonas J. B.
Universitäts-Augenklinik, Fakultät für Klinische Medizin Mannheim der Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
Purpose: Macular holes have usually been treated by pars plana
vitrectomy with or without removal of the inner limiting membrane of the
retina and ocular temporary endotamponade using inert gases. The purpose
of the present report is to describe the clinical course of a patient
in whom a macular hole persisted despite pars plana vitrectomy and maculorhexis,
and in whom a re-pars plana vitrectomy with perfluorohexyloctane (F6H8
) for endotamponade was performed.
Patient and Methods: A 60-years old patient presented with a macular
hole stage III and progressive loss of central vision to 0,20. Although
pars plana vitrectomy in combination with maculorhexis and endotamponade
using C3F8 gas was uneventfully performed, the macular hole persisted
after resorbtion of the intraocular gas. Visual acuity was 0.10 . A second
pars plana vitrectomy was carried out combined with cataract surgery,
implantation of a posterior chamber lens, and use of perfluorohexyloctane.
Perfluorohexyloctane was chosen since, due to its high specific weight,
it may be able to press the retina against the retinal pigment epithelium
and may reduce the risk of a further subretinal re-bleeding.
Results: Four weeks after surgery, a marked emulsification of perfluorohexyloctane
and formation of secondary cataract occurred. Intraocular pressure rose
to values of about 30 mm Hg. Seven weeks after surgery, the F6H8 was removed
during a third pars plana intervention. The macular hole was closed. The
whole retinal surface was covered by a whitish amorphous membrane which
could partially be aspirated or flushed away. Visual acuity improved to
0.30 .
Conclusions: Perfluorohexyloctane may possibly be a possibility
for ocular endotamponade of a macular hole. A marked early emulsification
of perfluorohexyloctane and the formation of a whitish epiretinal membrane
deserve further intensive consideration.