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

硅油、氟硅油、硅/氟硅共聚物油和全氟碳液体在玻璃体手术中作为手术工具或视网膜填充物治疗难治性视网膜脱离是有用的。六氟化硫气体和全氟丙烷气体也被用作视网膜填充物。用密度高于水、粘度相对较低的硅氟硅共聚物油注入兔玻璃体腔2个月后，下视网膜外丛状层消失。实验中发现，注射硅氟硅油2个月后，兔眼下视网膜光感受器LayR和单个核细胞在玻璃体腔或视网膜前被单核细胞消化的小颗粒出现异常。此外，有机硅/氟硅共聚物油溶抗增殖药物，如维甲酸，可减少增殖性玻璃体视网膜病变的发生。注射密度高于水、粘度高的氟硅油后，兔下视网膜外丛状层变薄或消失，光感受器层异常。虽然玻璃体手术治疗特发性黄斑裂孔或去除视网膜下脉络膜新生血管膜后视野丧失的原因尚不清楚，但可能的原因是眼内气体填充的影响。本研究观察了兔玻璃体腔内注射全氟丙烷气体和六氟化硫气体后，视网膜上段的组织病理学和组织细胞化学异常改变。

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.