Effects of Perfluorocarbon Liquids and Silicone Oil on Human Retinal Pigment Epithelial Cells and Retinal Ganglion Cells

Abstract

Perfluorocarbon liquid is directly toxic to ARPE-19 cells when exposed to the cells for 7 days. On the contrary, it seems that RGCs are damaged in a time-dependent manner by the more mechanical rather than toxic effects of PFCL. Silicone oil seems to exert mechanical rather than toxic effects on ARPE-19 cells. When PFCL is used as a postoperative tamponade clinically, understanding the difference in the effects will lead to more effective and safer results.

Vision loss under silicone oil tamponade

“…Toxicity of silicone oil to retina bound cells is a widely discussed mechanism. In vitro and in vivo studies have proposed a harmful effect of silicone oil to retinal structures, and toxic substances in removed silicone oil have been described [8][9][10][11][12]. Following this theory, silicone oil has to be in close proximity to retinal structures to be harmful.…”

“…The safety and efficacy of silicone oil in ophthalmic surgery has been demonstrated in many studies during the last decades [6,7]. A potential toxicity of silicone oil to the human retina has been denied [8,9]. Only a few authors have discussed a harmful effect of silicone oil to animal and human retinal structures, especially in long-term use [10][11][12].…”

Retinal detachment and gyrate atrophy of the choroid and retina: case report

“…We find it plausible, then, that the retinas of patients with this disease could have a natural outcome that often leads to very low VA, or they could be more sensitive to factors such as intraocular pressure, the height of the infusion bottle during vitrectomy surgery or contact with sili cone oil. Some studies have reported silicone oil toxicity to the optic nerve (8) , causing atrophy as well as having a damaging effect on the retinal pigment epithelium (RPE) (9) and an inflammatory action. Com paring this with a histopathologic study (10) that demonstrated altera tions at the RPE level by GA could explain, at least in part, the low VA.…”

Retinal Toxicity of Medical Devices Used during Vitreoretinal Surgery: A Critical Overview

“…In the past, these influences were hard to distinguish from functional damages caused by the underlying retinal pathology that lead to the necessity for a vitrectomy. As vitreoretinal surgery has become more elective, reports about retinal toxicity of, e.g., medical devices have emerged [13][14][15][16].…”

“…PFCL is considered to elicit inflammatory responses if left in the eye for longer periods of time and therefore should be removed completely at the end of surgery [31]. Retinal toxicity was formerly attributed to physical properties [13,32] as well as toxicity and presence of impurities [33,34]. It is important to mention that PFCL has been reported not to exert toxic effects as short-term tamponade (1-2 weeks) or even for long periods of time (although this is not recommended) [35].…”