gms | German Medical Science

The treatment of non-attached inferior retina after conventional silicone oil tamponade with perfluorohexyloctane (F₆H₈) seems to be an improved therapeutic approach. Own experience revealed severe complications after 3 months resting time of the F₆H₈. This study demonstrates short-term effects of F₆H₈ as tamponade for 3 weeks.

Casuistry. 12 patients (average age 61,5±21,5, 41 - 82 yrs) with complicated retinal detachment and previous surgical intervention (average 2,25 surgical treatments; 0 - 5 surgeries) were treated with pars plana vitrectomy and exchange of silicone oil against F₆H₈ as tamponade agent. Removal of the tamponade agent was performed 24 d post surgery (17 - 27 d).

All patients showed intraocular irritations, such as endothelial and retrolental precipitations or severe capsular fibrosis in case of pseudophacic eyes. Removal of the tamponade agent occurred without complications in all patients after an average of 24 d. Only minor retinal precipitations were seen. 7 of 12 patients experienced re-ablatio retinae shortly after removal of F₆H₈ with detachment of the superior or central retina. Severe cases of hypotonia as seen after 3 months treatment with F₆H₈ were not observed in this study. In comparison, patients who underwent panretinal laser coagulation prior to F₆H₈ treatment showed no detachment and retinal precipitates and only minor irritations.

F₆H₈ as a heavy liquid tamponade agent should only be administered after careful selection of patients. It seems - in our opinion - not suitable for routine treatment of complex retinal detachment. It remains to be investigated, if changes of the blood-retinal-barrier or the retinal contact area, e.g. after laser coagulation, have an influence on the therapeutic outcome.