Retinal toxicity of vitreous substitutes used in the difficult retinal detachment surger.

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Silicone oil, fluorosilicone oil, silicone/fluorosilicone copolymer oil, and perfluorocarbon liquids are useful as operative tools or retinal tamponades in vitreous surgery to treat difficult retinal detachement. Sulfur hexafluoride gas and perfluoropropane gas also are used as retinal tamponades. The use of silicone/fluorosilicone copolymer oil, which was a higher denstity than water and relatively low viscosity, resulted in the disappearance of the outer plexiform layr of the inferior retina 2 months after the oil was injected into the rabbit vitreous cabity. In the experiment, abnormalities of the photoreceptor layr in the inferior retina and small droplets digested by mononuclear cells in the rabbit vitreous cavity or preretina were found after 2 months in eyes injected with silicone/fluorosilicon copolymer oil. Furthemore, silicone/fluorosilicone copolymer oil-soluble antiproliferative drugs, such as retinoic acid, reduced the occurrence of proliferative vitreoretinopathy formation. Thinning or disappearance of the outer plexiform layr and abnormalities of the photoreceptor layr in the rabbit inferior retina were observed after eyes were injected with fluorosilicone oil, which has a higher density than water and high viscosity. Although the cause of visual field loss is unknown after human vitreous surgery with fluid/gas exchange to treat idiopathic macular hole or remove subretinal choroidal neovascular membranes, a possible cause may be the effects of intraocular gas tamponade. In the present study, histopathologically and histocytochemically abnormal findings were observed in the superior retina after perfluoropropane gas and sulfur hexafluoride gas wers injected into the rabbit vitreous cavity.