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Further evidence for proinflammatory nature of perfluorohexyloctane in the eye
Author(s) -
Vote Brendan,
Wheen Lyndsae,
Cluroe Alison,
Teoh Heng,
McGeorge Archibald
Publication year - 2003
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1046/j.1442-9071.2003.00687.x
Subject(s) - vitrectomy , medicine , retinal detachment , proinflammatory cytokine , tamponade , immunohistochemistry , ophthalmology , pathology , retinal , retrospective cohort study , inflammation , visual acuity , immunology
Background: The authors present a clinicopathological report of their initial experience with perfluorohexyloctane (F6H8), a novel semifluorinated liquid fluorocarbon developed as a long‐term vitreous substitute. Methods: A retrospective observational review was performed of five patients in whom F6H8 had been used for management of rhegmatogenous retinal detachment. Surgical specimens taken from two patients at the time of F6H8 removal were also submitted for histopathological, immunohistochemical and electron microscopic analysis. Results: Clinical and histological analysis of the present small case series confirmed the propensity of F6H8 to emulsify, and suggested a probable biological reaction to F6H8. Surrounding and engulfing the F6H8 were numerous cells morphologically in keeping with macrophages. Immunohistochemistry confirmed macrophage phenotype but electron microscopic evaluation showed epithelial ultrastructural features. It is suggested that the finding of macrophagic phenotype in cells with epithelial ultrastructure provides further evidence for a continuum of phenotypic differentiation of the pigment epithelial cells as part of the repair and regeneration that is the proliferative vitreoretinopathy (PVR) response. Conclusions: The data do not indicate any benefit of F6H8 over other perfluorocarbons for use in short‐term postoperative intraocular tamponade. Although early experience suggests that F6H8 use in primary vitrectomy with minimal PVR is acceptable and produces temporary inflammatory effects only, these cases can often be successfully managed by conventional scleral buckling techniques, or vitrectomy with standard tamponading agents, without the need for F6H8 and subsequent extra surgical procedures. Furthermore in eyes already predisposed to inflammation through prior surgery and/or presence of PVR, the inflammatory effects were not insignificant. The use of F6H8 is not recommended in the clinical setting, except as part of a controlled trial subject to the approval of an ethics committee and informed consent.