Complications caused by perfluorocarbon liquid used in pars plana vitrectomy

Article information

Kosin Med J. 2015;30(2):123-130

Publication date (electronic) : 2015 January 20

doi : https://doi.org/10.7180/kmj.2015.30.2.123

Jae Ho Yoo ¹, Ki Yup Nam ², Seung Uk Lee ², Ji Eun Lee ², Sang Joon Lee ²^,

¹Oksan Health Subcenter, Euiseong-Gun, Korea

²Department of Ophthalmology, College of Medicine, Kosin University, Busan, Korea

Corresponding Author: Sang Joon Lee, Department of Ophthalmology, College of Medicine, Kosin University, 262, Gamcheon-ro Seo-gu, Busan 49267, Korea TEL: +82-51-990-6228 FAX: +82-51-990-3026 E-mail: hhiatus@gmail.com

Received 2014 February 20; 2014 May 24; Accepted 2014 July 09.

Abstract

Objectives

To assess the inadvertent intraocular retention of perfluorocarbon liquid (PFCL) after vitreoretinal surgery and their complications.

Methods

We retrospectively reviewed the medical records of 108 patients who underwent vitreoretinal surgeries using intraoperative PFCL (perfluoro-n-octane (C₈F₁₈), 0.69 centistoke at 25℃, PERFLUORN®, Alcon, USA) and the removal of PFCL through fluid-air exchange. The analysis was focused on the occurrence of intraocular retained PFCL, diagnoses, surgicalprocedures, and complications.

Results

Retinal detachment (51 cases, 47%) was the most common surgery which used PFCL intraoperatively. Other causes were vitreous hemorrhage (24 cases, 22%), posteriorly dislocated lens (22 cases, 21%), and trauma (11 cases, 10%). Intraocular PFCL was found in a total of 9 (8.3%) eyes. PFCL bubbles remained in anterior chamber and vitreous cavity were observed in 4 cases and subretinal retained PFCL was observed in 5 cases. Three of 5 cases of subretinal PFCL exhibited in subfoveal space. Among the three subfoveal cases, macular hole developed after PFCL removal in 1 case, epiretinal membrane in the area where had been PFCL bubble. However, we observed no complications in 1 case of subfoveal PFCL that was removed by surgery. PFCL in anterior chamber and vitreous cavity were in 4 cases.

Conclusions

The presence of subfoveal PFCL might affect visual and anatomic outcomes. However, subfoveal PFCL may induce visual complications, and therefore requires special attention.

Keywords: complicaton; Perfluorocarbon liquid; retinal detachment; Vitrectomy

Fig. 1.

A. Anterior segment Photo shows multiple PFCL bubble in inferior anterior chamber.(red arrow) B. Postoperative retinography of case 5 showing multiple PFCL spheres in the posterior pole, extramacular.(red arrow) After 2 years, notice the reflexes caused by PFCL. The patient's visual acuity was 0.25. C. Postoperative retinography shows PFCL bubble at superior side of macula.(red arrow) D.Vertical OCT section of the "C" case was shown and the intraretinal black hollow (arrow head) was PFCL subretinal bubble.

Fig 2.

A. Retinography shows round reflex at macular due to subfoveal PFCL and atrophic change around posterior pole due to laser treatment. B. After 48 months with secondary IOL implant, retinography shows no obvious anatomy changes.(red arrow) The patients last visual acuity was 0.125. C.Vertical OCT section of the "B" case was shown and subfoveal PFCL bubble was observed.(blue arrow head) D. Postoperative retinography showing yellowish glistening macula due to submacular PFCL.(red arrow) E. After 6 months, retinography shows inferiorly displaced PFCL (red arrow) and premacular gliosis and epiretinal membrane.(blue arrow head)

Table 1.

Demographics of total patient and retained PFCL cases.

Table 2.

Cumulative Percent of Eyes with Retained Perfluorocarbon Liquid

Table3.

Patient Characteristics with retained PFCL

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