Vote Brendan, Wheen Lyndsae, Cluroe Alison, Teoh Heng, McGeorge Archibald
Department of Ophthalmology, University of Auckland, Auckland, New Zealand.
Clin Exp Ophthalmol. 2003 Oct;31(5):408-14. doi: 10.1046/j.1442-9071.2003.00687.x.
The authors present a clinicopathological report of their initial experience with perfluorohexyloctane (F6H8), a novel semifluorinated liquid fluorocarbon developed as a long-term vitreous substitute.
A retrospective observational review was performed of five patients in whom F6H8 had been used for management of rhegmatogenous retinal detachment. Surgical specimens taken from two patients at the time of F6H8 removal were also submitted for histopathological, immunohistochemical and electron microscopic analysis.
Clinical and histological analysis of the present small case series confirmed the propensity of F6H8 to emulsify, and suggested a probable biological reaction to F6H8. Surrounding and engulfing the F6H8 were numerous cells morphologically in keeping with macrophages. Immuno-histochemistry confirmed macrophage phenotype but electron microscopic evaluation showed epithelial ultra-structural features. It is suggested that the finding of macrophagic phenotype in cells with epithelial ultra-structure provides further evidence for a continuum of phenotypic differentiation of the pigment epithelial cells as part of the repair and regeneration that is the proliferative vitreo-retinopathy (PVR) response.
The data do not indicate any benefit of F6H8 over other perfluorocarbons for use in short-term post-operative intraocular tamponade. Although early experience suggests that F6H8 use in primary vitrectomy with minimal PVR is acceptable and produces temporary inflammatory effects only, these cases can often be successfully managed by conventional scleral buckling techniques, or vitrectomy with standard tamponading agents, without the need for F6H8 and subsequent extra surgical procedures. Furthermore in eyes already predisposed to inflammation through prior surgery and/or presence of PVR, the inflammatory effects were not insignificant. The use of F6H8 is not recommended in the clinical setting, except as part of a controlled trial subject to the approval of an ethics committee and informed consent.
作者呈现了他们对全氟己基辛烷（F6H8）的初步临床病理报告，F6H8是一种新型的半氟化液态碳氟化合物，被开发用作长期玻璃体替代物。
对5例使用F6H8治疗孔源性视网膜脱离的患者进行了回顾性观察研究。在取出F6H8时从2例患者获取的手术标本也被送去进行组织病理学、免疫组织化学和电子显微镜分析。
对当前这个小病例系列的临床和组织学分析证实了F6H8有乳化倾向，并提示对F6H8可能存在生物学反应。在F6H8周围并将其吞噬的是许多形态上与巨噬细胞一致的细胞。免疫组织化学证实为巨噬细胞表型，但电子显微镜评估显示为上皮超微结构特征。提示在具有上皮超微结构的细胞中发现巨噬细胞表型为色素上皮细胞表型分化的连续性提供了进一步证据，这是增殖性玻璃体视网膜病变（PVR）反应修复和再生的一部分。
数据未表明F6H8在短期术后眼内填充方面比其他全氟化碳有任何优势。尽管早期经验表明在原发性玻璃体切除术中使用F6H8且PVR轻微是可以接受的，并且仅产生暂时的炎症效应，但这些病例通常可以通过传统的巩膜扣带技术或使用标准填充剂的玻璃体切除术成功处理，而无需使用F6H8及后续额外的手术步骤。此外，在因既往手术和/或存在PVR而易于发生炎症的眼中，炎症效应并非微不足道。除了作为经伦理委员会批准并获得知情同意的对照试验的一部分外，不建议在临床环境中使用F6H8。
