Development and initial experience with a colored perfluorocarbon liquid for intraocular tamponade in vitreoretinal surgery.
OBJECTIVE
To present the development and initial experience of a novel colored perfluorocarbon liquid (PFCL) in vitreoretinal surgery.


METHODS
This was an experimental laboratory study and prospective human interventional study. F6H8 (Fluoron GmbH) was colored by adding 0.3 g/L blue anthraquinone dye. Subsequently, 20% colored F6H8 was prepared by mixing with perfluorooctane or perfluorodecalin (Fluoron GmbH). The novel product is not yet FDA approved for human application. In the laboratory, the colored PFCL was covered with 1) uncolored PFCL, 2) BSS, and 3) silicone oil. Cell toxicity was evaluated in L929 mouse fibroblasts using a growth inhibition assay. Porcine ex vivo eyes were evaluated after vitrectomy followed by intravitreal and subretinal colored PFCL infusion. A pilot, prospective, noncomparative interventional study was conducted in patients with retinal detachment with proliferative vitreoretinopathy (PVR).


RESULTS
The density of the colored PFLC mixture was 1.664 g/cm for perfluorooctane and 1.802 g/cm for perfluorodecalin. There was no relevant cell growth inhibition with any concentration of colored PFCL tested. Experiments in pigs revealed that infusion of the colored PFCL caused neither staining of the internal limiting membrane nor intravitreal residual droplets. In the prospective study, 9 eyes (75%) underwent surgery for rhegmatogenous retinal detachment with at least grade C PVR. The colored PFCL enabled retinal break examination and detection of residual intravitreal droplets in all surgeries. There was no case of separation or leakage of the dye from the PFCL solution that could have caused unwanted staining of the vitreous or epiretinal surface.


CONCLUSIONS
The colored PFCL enabled intraoperative maneuvers such as endolaser use. In addition, removal of the colored PFCL was easily achieved at the end of surgery.
Vision Institute (IPEPO), Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil.
Eduardo B
EB
Rodrigues
Helio
H
Shiroma
Fernando M
FM
Penha
Mauricio
M
Maia
Milton N
MN
Moraes-Filho
Magno
M
Ferreira
Renata
R
Portella
Eduardo
E
Novais
Nadine
N
Hagedorn
Michel E
ME
Farah
D000328:Adult; D000368:Aged; D000818:Animals; D000880:Anthraquinones / Q000737:chemistry / Q000633:toxicity; D049109:Cell Proliferation / Q000187:drug effects; D004396:Coloring Agents / Q000627:therapeutic use* / Q000633:toxicity; D004195:Disease Models, Animal; D058450:Endotamponade / Q000379:methods; D005260:Female; D005347:Fibroblasts / Q000187:drug effects; D005466:Fluorocarbons / Q000627:therapeutic use* / Q000633:toxicity; D006801:Humans; D008297:Male; D051379:Mice; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012163:Retinal Detachment / Q000601:surgery*; D013552:Swine; D057586:Vitreoretinal Surgery / Q000379:methods*; D018630:Vitreoretinopathy, Proliferative / Q000601:surgery*
D000880:Anthraquinones; D004396:Coloring Agents; D005466:Fluorocarbons; C008805:perfluorodecalin; C073608:perfluorooctane