PERFLUORODECALIN CORNEAL TOXICITY - 5 CASE-REPORTS

Perfluorodecalin is a perfluorocarbon liquid used intraoperatively in retinal detachment repair. It is usually removed at the end of the pro cedure; however, residual amounts may be retained when poor corneal cl arity or intraocular hemorrhage obscures the view. No clinical reports exist on the consequences of retained perfluorodecalin in the anterio r segment. We report five cases in which perfluorodecalin was in prolo nged contact with the cornea. The period of time for corneal pathology to occur and the role perfluorodecalin played in the etiology of such changes is discussed. A total of 348 patients with retinal detachment s in one retinal practice underwent repair using pars plana vitrectomy combined with intraoperative perfluorodecalin between January 1992 an d May 1994. Postoperatively, residual perfluorodecalin was observed in the anterior chamber in contact with the corneal endothelium in five patients. The patients were followed clinically for a period of up to 18 months. Four of five patients developed corneal changes from prolon ged contact with perfluorodecalin. Corneal edema developed in the area of perfluorodecalin-endothelial contact in three of five eyes. The pe riod of perfluorodecalin-endothelial contact before corneal decompensa tion occurred ranged from 4 to 13 weeks. Two eyes required penetrating keratoplasties for progressive corneal edema. Corneal edema was rever sed in one eye after removal of perfluorodecalin from the anterior cha mber via multiple paracentesis. One of the remaining eyes developed de ep corneal vascularization without edema in the area of perfluorodecal in contact after 12 months. These observations suggest that corneal to xicity may be induced by intraocular perfluorodecalin if it is allowed direct contact with the corneal endothelium for periods as short as 1 month. Some of these changes may be reversible if perfluorodecalin is aspirated from the anterior chamber. Further investigations are requi red to examine perfluorodecalin-induced corneal toxicity.