Subretinal perfluorocarbon liquids. An experimental study

Perfluorocarbon liquids (PFCL) are fully fluorinated, synthetic, transparent compounds with a high specific gravity. These compounds are being increasingly used as an intraoperative tool for repair of complicated retinal detachments. A known complication of their use, however, is liquid entering the subretinal space via a retinal break. The purpose of this study was to evaluate the effects of two of these liquids when placed subretinally in the rabbit eye. Vitrectomy, retinotomy, and subretinal injection of 0.03 cc of either perfluoroctane, perfluorotributylamine, or balanced salt solution (control eyes) were performed on 36 rabbit eyes. Animals were monitored clinically by indirect ophthalmoscopy and fundus photography for up to 21 days. After the 21-day observation period, electroretinograms (ERG) were taken before the rabbits were killed. Histopathologic studies were done at 3 hours, 24 hours, 3 days, 7 days, 14 days, and 21 days after injection. Three eyes demonstrated tearing of the retinotomy site due to downward migration of the PFCL droplet. Results of the ERGs were normal in all animals tested. Phagocytosis of PFCL droplets by the retinal pigment epithelium (RPE) was observed in 1 eye 3 hours after injection. Three of the eyes that received PFCL injections and all of the control eyes demonstrated moderate intracellular edema of both inner and outer nuclear layers as early as 24 hours after injection. In one eye injected with PFCL, these changes progressed to swelling and cystic formation of the inner nuclear layer and mild degeneration of the outer photoreceptor segments 3 days after injection. It was assumed that these effects occurred on a mechanical basis and were not related to PFCL toxicity.(ABSTRACT TRUNCATED AT 250 WORDS)