The Experimental And Clinic Study Of Application Of Perfluorodecalin In Ocular Tissue

Objective : Perflurocarbon liquids is an important vitreous substitute in Vitreoretinal Surgery(VRS), Perfluorodecalin (PFDL) is one kind of Perflurocarbon ,and is fully fluorinated, synthetic, transparent compounds with high gravity, low viscosity , high boiling point and strong ability of combination with oxygen , can float lens and foreign bodies ,flatten and immobilize retina, reduce injuries in operation , be suitable as an intraoperative tool during VRS , and has been widely used in VRS , as to the toxicity of PFDL to cornea and retina ,at present the studies were clinic ,and there were many unclear problem . Our studies include animal experiment and clinic studies ,a way of ocular injection of PFDL were used in animal experiment ,in order to study the toxicity of PFDL , and study the relationship between the toxicity of PFDL and period of retention, amount of intraocular retention , the mechanism of PFDL toxicity and study the means of avoiding intraocular remnent ,we estimated the histopathologic and ultrastructure change of cornea, angle of anterior chamber, retina and optic nerve of ribbit .and also by means of Corneal specular microscope , elcctroretinogram(ERG) ,ultrasound biomicroscopy(UBM ) and visual evoked potcntial(VEP)In our clinic studies we evaluated the effect of PFDL in VRS treatingcomplicated retinal detachment(RD), proliferative diabetic retinopathy (PDR),vitreous hemorrhage, complication of VRS , RD after silicone oil tamponades ,and observed whether the remnent of PFDL could cause lesion and infection , givemeans of preventing ocular remnent of PFDL.Method : Both animal experimental study and clinic study were used tostudy the injury of PFDL to ocular tissue .1 The animal experimental study of application of PFDL in ocular tissue 32 health ribbits were used ,and were divided into anteriorchamber group and vitreous cavity group by random , different amount of PFDl. were injected into anterior chamber and vitreous cavity, 6h 24h 72h 7d, Imon and 2mons after operation ,(). slit-lamp microscope and indirect ophthalmoscope were used to exam cornea > iris x character of PFDL , hole and detachment of retina.(2). ERG and visual VHP were used to exam the function of retina and optic nerve. (3) Corneal specular microscope were used to exam the function and shape of corneal endothelium .(4).UBM were used to exam the change of cornea > iris and angle of anterior chamber. (5).Cornea > angle of anterior chamber retina and optic nerve were studied by light microscopy and transmission electric microscopy .2. The clinic study of application of PFDL in ocular tissue 245 clinical cases were studied ,among them were complicated RD 175 eyes PDR 21 eyes, vitreous hemorrhage caused by other reason 27 eyes acute retinal necrosis syndrome(ARN) 2 eyes endophthalmia 3 eyes Coats disease 1 eye , old choroid hemorrhage 1 eye complication of VRS 6 eyess RD after silicone oil tamponades 9 eyes. VRS involving the peeling of pre-retinal membrane PFDL injection endolaser fluid air exchange and inert gas or silicone oil tamponades . Probed the way of avoiding remnent of PFDL in VRS , "permutation of PFDL after air-fluid exchange was used in macular hole or posterior pole hole,that is air-fluid exchange first to flatten retina, then PFDL was injected , "part air-fluid exchange associate with the use of PFDL"was used in grand retina tear, that is part of PFDL was injected first, then air-fluid exchange,and silicone oil or air exchange with PFDL ; " PFDL was used step by step in 360皉etinotomy ", that is part stiff retina was incised , then injected part PFDL ,incise stiff retina step by step ,peel proliferative membrane and draging tissue ,then injected PFDL, to avoid shifting of retina and PFDL flowing into subretina. Slit-lamp microscope andindirect ophthalmoscope were used to exam the change of cornea, iris and retina , and cases of remnent were also observed.