Perfluorohexylethan (O62) as ocular endotamponade in complex vitreoretinal surgery

Purpose: To investigate the safety and performance of perfluorohexylethan (O-62), a partially fluorinated alkane, as an intraoperative tool and heavy ocular endotamponade in complex vitreoretinal surgery. Patients and Methods: In a prospective clinical study, O-62 was used as a postoperative ocular endotamponade in 11 eyes of 11 patients after pars plana vitrectomy for the following inferior pathologic conditions, proliferative vitreoretinopathy (n=8), rhegmatogenous retinal redetachment with inferior tears (n=1), and inferior giant tear (n=2). The median duration of the O-62 tamponade was 43 days (range, 17-55 days), and the median follow-up period after removal of the tamponade was 16 months. Results: The initial postoperative retinal attachment rate was 100%. In 7 of 11 eyes, the retina remained attached during the O-62 tamponade and after its removal. During the tamponade period, no epiretinal membrane formation or macular pucker was observed in these seven eyes. Recurrent retinal detachments with proliferative vitreoretinopathy developed in 4 of 11 eyes under the tamponade. The median follow-up after removal of O-62 was 16 months. A secondary cataract developed in all five phakic eyes. Severe emulsification was noted in all patients starting in the second week after surgery causing a decrease of visual acuity and a significantly reduced funduscopic view. In the early postoperative period, a marked inflammatory reaction in the anterior segment was seen in all patients. Slightly whitish precipitates were noted in 2 of 11 eyes. A transient increase in intraocular pressure up to 35 mmHg was observed in 2 of 11 eyes. Conclusion: O-62 showed good tamponade properties for the inferior retina over 6 weeks. However, its use as a postoperative retinal tamponade is limited by its severe emulsification propensity and unclear inflammatory potential.