Perfluorodecaline residue in the anterior chamber of a patient with an intact crystalline lens: a case report

Abstract Background Perfluorocarbon liquids are frequently used as intraoperative tools in vitreoretinal surgery and may occasionally be retained in the vitreous cavity. We report a patient who underwent pars plana vitrectomy for a giant tear after receiving blunt trauma to his right eye and sustained postoperative perfluorocarbon liquid residue in the anterior chamber in spite of an intact crystalline lens. Case presentation Perfluorodecaline was used as a temporary retinal tamponade. Three weeks after the surgery, a residue of heavy liquid was observed in the anterior chamber, even though the patient had an intact crystalline lens without any tilt or dislocation. The remnant of the heavy liquid was taken out of the anterior chamber immediately to avoid secondary complications. Conclusion Presence of heavy liquids in the anterior chamber may be associated with zonular defects even though the patient has an intact crystalline lens.</p

Evidence for Diffuse Central Retinal Edema In Vivo in Diabetic Male Sprague Dawley Rats

Background: Investigations into the mechanism of diffuse retinal edema in diabetic subjects have been limited by a lack of animal models and techniques that co-localized retinal thickness and hydration in vivo. In this study we test the hypothesis that a previously reported supernormal central retinal thickness on MRI measured in experimental diabetic retinopathy in vivo represents a persistent and diffuse edema. Methodology/Principal Findings: In diabetic and age-matched control rats, and in rats experiencing dilutional hyponatremia (as a positive edema control), whole central retinal thickness, intraretinal water content and apparent diffusion coefficients (ADC, ‘water mobility’) were measured in vivo using quantitative MRI methods. Glycated hemoglobin and retinal thickness ex vivo (histology) were also measured in control and diabetic groups. In the dilutional hyponatremia model, central retinal thickness and water content were supernormal by quantitative MRI, and intraretinal water mobility profiles changed in a manner consistent with intracellular edema. Groups of diabetic (2, 3, 4, 6, and 9 mo of diabetes), and age-matched controls were then investigated with MRI and all diabetic rats showed supernormal whole central retinal thickness. In a separate study in 4 mo diabetic rats (and controls), MRI retinal thickness and water content metrics were significantly greater than normal, and ADC was subnormal in the outer retina; the increase in retinal thickness was not detected histologically on sections of fixed and dehydrated retinas from these rats

Acetylsalicylic acid–silicone oil suspension for proliferative vitreoretinopathie: First results of Austrian clinical multicentre study

BACKGROUND: A new surgical method of intravitreal tamponade with silicone oil suspended with acetylsalicylic acid (AS) was investigated for safety and efficiency in the treatment of proliferative vitreoretinopathie. The study was designed as a prospective randomized, controlled double-blind Multicentre Study. METHODS: A standard three-port pars plana vitrectomy was performed in 29 eyes of 29 patients. In case a natural lens was present simultaneous phacoemulsification was obligatory. The control group received standard therapy vitreous tamponade with pure 5000centistoke silicone oil while the silicone oil was suspended with AS to a concentration of 0.2 mg/ml in the study group. After 6 months follow up the tamponade was removed in all eyes. RESULTS: The safety of AS SiO could be demonstrated: the AS SiO was well tolerated and stayed clear during the study period of 6 months. The clinical examination revealed no signs of local or systemic adverse effects in the study eyes. The visual acuities were well matched before inclusion into the study and there was no evidence of significant differences during the follow up period and in final visual outcome between the two groups. The rate of redetachments defined as the primary outcome parameter was the same for both groups. CONCLUSIONS: Acetylsalicylic acid delivery by intravitreal silicone oil in the human eye was shown a safe method that may offer a delivery route for other antiproliferative agents into the posterior pole.HINTERGRUND: Eine neue Form der intravitrealen Tamponade mit einer Suspension aus Azetyl-Salizylsäure und Silikonöl (AS SiO) wurde einer klinischen Prüfung unterzogen. Die Studie wurde als doppelt-blinde, randomisierte, multizentrische, prospektive Studie konzipiert, um die Sicherheit und Effektivität von AS SiO als Glaskörpertamponade bei proliferativer Vitreoretinopathie (PVR) zu evaluieren. METHODE UND PATIENTEN: Insgesamt 29 Augen von 29 Patienten mit einer PVR Grad C wurden in der Studie entweder einer Pars-Plana Vitrektomie mit anschließender AS-SiO- oder reiner SiO-Tamponade unterzogen. Die Azetyl-Salizylsäure-Konzentration der Suspension betrug 0,2 mg/ml und es wurde in beiden Gruppen jeweils 5000centistoke Silikonöl verwendet. Bei Phakie war zeitgleich eine Operation der Linse obligatorisch, um eventuell AS-SiO-bedingte Linsentrübungen zu vermeiden. Nach 6 Monaten wurde die Tamponade bei allen Patienten entfernt. Im Fall noch vorliegender Traktionen oder instabiler Verhältnisse war eine Retamponade mit reinem SiO natürlich möglich. ERGEBNISSE: Die Sicherheit von AS SiO konnte nachgewiesen werden. Es wurde in allen Augen gut toleriert und die Suspension blieb transparent innerhalb der Beobachtungszeit von 6 Monaten. Die klinische Untersuchung ergab keine Hinweise einer lokalen oder systemischen Toxizität. Die Visuswerte beider Gruppen unterschieden sich nicht signifikant sowohl präoperativ als auch postoperativ. Auch in Bezug auf die Rate der Reablationes, dem Hauptzielkriterium der Studie, waren beide Gruppen gleichwertig. SCHLUSSFOLGERUNG: Die Azetyl-Salizylsäure- und Silikonöl-Suspension (AS SiO) repräsentiert eine sichere und effektive Tamponade im Rahmen der PVR-Behandlung. Zusätzlich beweist sie, dass es möglich ist, mittels Silikonöl Medikamente in den posterioren Augenabschnitt zu verabreichen, wobei hier vor allem der Transfer antiproliferativer Substanzen interessant ist