Atlas of Ophthalmology

Residual Extrafoveal Subretinal Perfluorocarbon Liquid Droplets after Vitrectomy (Colour Photography Posterior Segment, SD-OCT)

Retina -> Surgical Procedures y Casos Post-Quirúrgicos -> Complicationes
Patient: 60 years of age, male, BCVA 0.1, IOP 16 mmHg. Ocular Medical History: in 2008 retrobasal giant retinal tear with vitrectomy, in 2012 macular hole with re-vitrectomy, PFCL perfluoroctane was used to assist surgery. Retained subfoveal PFCL bubbles were noticed by funduscopy and optical coherence tomography. General Medical History: Main Complaint: patient represented with metamorphopsia and vision of 20/200 Purpose: to demonstrate subretinal perfluorocarbon liquid droplets after intraoperative use of perfluorocarbon liquid. Methods: Colour Photography Posterior Segment, SD-OCT (Heidelberg Engineering, Heidelberg, Germany). Findings: Colour Photography Posterior Segment: retained subretinal perfluorocarbon liquid droplets. SD-OCT: retained subretinal perfluorocarbon liquid droplets. Discussion: Perfluorocarbon liquids (PFCL) are synthetic and transparent compounds with a high specific gravity which are very useful for vitreoretinal surgery. Despite careful removal of residual PFCLs droplets, some may occasionally be retained. Experimental subretinal injection of PFCLs results in phagocytosis of PFCL by RPE within 3 h of injection (1). Romano et al (1) found in an epimacular membrane after intraoperative use of perfluorocarbon liquid a markedly different microscopic appearance, with extracellular matrix formation and grossly swollen RPE cells that appeared to contain tamponade agent. Early intervention appears to be warranted particularly if central vision remains at risk with subfoveally located droplets. Literature: (1) Romano MR, Baddon C, Heimann H, Wong D, Hiscott P. Histopathological findings in an epimacular membrane after intraoperative use of perfluorocarbon liquid. Eye (Lond). 2010 Apr;24(4):740-2.

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