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Perfluorhexyloktan (F6H8) als Endotamponade bei Patienten mit komplizierter Netzhautablösung

Ergebnisse nach 6 Monaten

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Zusammenfassung

Hintergrund

Mit Perfluorhexyloktan (F6H8) wurde erstmalig ein schweres Medium (Dichte >1g/cm3) zur postoperativen Endotamponade (bis 3 Monate) in der vitreoretinalen Chirurgie verfügbar. Langzeitige Nachbeobachtungen nach F6H8-Anwendung liegen nicht vor.

Fragestellung

Analyse der Effizienz und Verträglichkeit von F6H8 an Augen mit Reablatio nach vorangegangenen retinalen/vitreoretinalen Eingriffen.

Patienten und Methoden

Klinische Verlaufsanalyse während/nach Anwendung von F6H8 (17 Patienten). Anwendungsdauer im Median 25 Tage. Nachbeobachtungszeit: 6 Monate nach F6H8-Entfernung.

Ergebnisse

Bei 16/17 Augen konnte durch F6H8-Anwendung eine primäre Netzhautanlage erzielt werden. An 8 Augen stellte sich im Nachbeobachtungszeitraum eine Reablatio ein. Nach Reoperation Netzhautanlage vollständig bei 12/17, stabile partielle Ablatio an 4/17 und totale Ablatio an 1/17 Augen. Häufigste Komplikationen der F6H8-Anwendung waren Dispersion 17/17, Hypotonie 14/17, ausgeprägte Zellpräzipitate von Linse/Vordersegment 7/17, starke Kapselfibrose 8/17 und Keratopathie 6/17.

Schlussfolgerungen

Der hohe Anteil chronischer Hypotonien scheint die Anwendbarkeit von F6H8 bei mehrfach voroperierten Augen erheblich zu limitieren.

Abstract

Background

Perfluorohexyloctane (F6H8) is the first medium that can be transiently used as postoperative heavy vitreous substitute expanding the technique of intraocular tamponade by the principle of an inferiorly acting medium. Legally it can be used for up to 3 months. So far very few clinical reports are available on the efficacy and possible complications of F6H8. It was the aim to analyze this in a group of patients with retinal redetachment after one or several previous retinal/vitreoretinal interventions.

Patients and methods

This study included 17 patients (10 male, 7 female, median age 66 years, range 34–88 years) with a complicated retinal redetachment (at least inferior quadrants). Median duration of intraocular F6H8 use was 25 days. Follow-up was limited to 6 months.

Results

Primary retinal reattachment could be achieved in 16/17 eyes. 8/17 developed retinal redetachment during follow-up. After additional surgery 12/17 presented complete retinal attachment, 4/17 subtotal attachment and 1/17 total retinal detachment. The latter was enucleated as a consequence of several further complications such as chronic hypotony, severe keratopathy and painful atrophy. The spectrum of complications during and after F6H8 tamponade included dispersion 17/17 (10/17 clinical, 7/17 minor), hypotony (endpoint) 14/17, massive cell precipitation on lens/IOL or in the anterior segment 7/17, severe progression of capsular fibrosis (8/17), and keratopathy 6/17.

Conclusions

The spectrum of postoperative complications after F6H8 use, especially the high proportion of eyes with chronic hypotony, indicates that F6H8 may not be a recommendable option in eyes with a complicated surgical history.

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Danksagung

Die Autoren bedanken sich bei Helga Ezelius für die kritische Durchsicht und Hilfe bei der Manuskriptbearbeitung.

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Authors and Affiliations

  1. Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Münster

    H. Gerding & A. Kolck

  2. Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Münster, Domagkstraße 15, 48129 , Münster

    H. Gerding

Authors
  1. H. Gerding
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  2. A. Kolck
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Correspondence to H. Gerding.

Additional information

In Auszügen vorgetragen auf der 100. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft in Berlin, 26.9.–29.9.2002.

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Gerding, H., Kolck, A. Perfluorhexyloktan (F6H8) als Endotamponade bei Patienten mit komplizierter Netzhautablösung. Ophthalmologe 101, 255–262 (2004). https://doi.org/10.1007/s00347-003-0932-x

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  • DOI: https://doi.org/10.1007/s00347-003-0932-x

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