Perfluorohexylethan (O62) as ocular endotamponade in complex vitreoretinal surgery

Abstract

Purpose: To investigate the safety and performance of perfluorohexylethan (O62), a partially fluorinated alkane, as an intraoperative tool and heavy ocular endotamponade in complex vitreoretinal surgery.

Patients and methods: In a prospective clinical study, O62 was used as a postoperative ocular endotamponade in 11 eyes of 11 patients after pars plana vitrectomy for the following inferior pathologic conditions, proliferative vitreoretinopathy (n = 8), rhegmatogenous retinal redetachment with inferior tears (n = 1), and inferior giant tear (n = 2). The median duration of the O62 tamponade was 43 days (range, 17-55 days), and the median follow-up period after removal of the tamponade was 16 months.

Results: The initial postoperative retinal attachment rate was 100%. In 7 of 11 eyes, the retina remained attached during the O62 tamponade and after its removal. During the tamponade period, no epiretinal membrane formation or macular pucker was observed in these seven eyes. Recurrent retinal detachments with proliferative vitreoretinopathy developed in 4 of 11 eyes under the tamponade. The median follow-up after removal of O62 was 16 months. A secondary cataract developed in all five phakic eyes. Severe emulsification was noted in all patients starting in the second week after surgery causing a decrease of visual acuity and a significantly reduced funduscopic view. In the early postoperative period, a marked inflammatory reaction in the anterior segment was seen in all patients. Slightly whitish precipitates were noted in 2 of 11 eyes. A transient increase in intraocular pressure up to 35 mmHg was observed in 2 of 11 eyes.

Conclusion: O62 showed good tamponade properties for the inferior retina over 6 weeks. However, its use as a postoperative retinal tamponade is limited by its severe emulsification propensity and unclear inflammatory potential.