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Results after Perfluorhexyloctane (F6H8) Internal Tamponade in Patients after Complicated Retinal Detachment Surgery
1Gerding H., 2Kolck A.,
1Westfälische Wilhelms-Universität Münster, Augenklinik (Münster)
2 (Münster)
Background: It was the aim of this study to analyze the efficacy of transient F6H8 internal tamponade in a group of retinal patients with poor prognosis after multiple and complicated surgical interventions.
Methods: Internal tamponade by F6H8 was applied in 17 patients (17 eyes, f=7, m=10, age median: 66 years, range: 34-88) with partial retinal detachment in the lower quadrants (15 x PVR, 2 x traumatic). The majority of patients (16) was subject to two or more previous major retinal interventions (buckle procedures, vitrectomy, range: 1-6). Median follow-up was 8 months after F6H8 removal (range: 1-26). F6H8 procedures were representing 0.85 % of all major retinal interventions (n=1989) during the study period (1.1.1999 - 31.12.2001) at our department. F6H8 internal tamponade was supported by intraoperative laser coagulation and postoperatively by the guided positioning of patients. In none of the cases retinotomies or retinectomies were performed during F6H8 procedure. Internal F6H8 tamponade remained in the eye for a median period of 25 days (range: 7-36).
Results: In 6 of 17 eyes (35 %) the transient F6H8 internal tamponade procedure resulted in a permanent and complete retinal reattachment. In 5 eyes the same result was achieved after additional surgery following F6H8 removal so that the total success rate was 65 % (11/17). In all eyes a pronounced dispersion of F6H8 and the formation of pigmented and weakly adherent cellular precipitates was observed until the time of removal. Secondary glaucoma did not develop in any of the cases. 2/4 phacic patients developed a rapidly progressive cataract after F6H8 removal.
Conclusions: A transient use of F6H8 as internal tamponade seems to be efficient for the management of eyes with poor prognosis after multiple complicated vitreoretinal procedures. A definitive evaluation of this procedure should be subject to a randomized clinical trial.