Acute intraocular toxicity caused by perfluorocarbon liquids: safety control systems of medical devices.
Graefes Arch Clin Exp Ophthalmol 2022;
260:2103-2110. [PMID:
35122500 PMCID:
PMC8817148 DOI:
10.1007/s00417-022-05578-w]
[Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/20/2022] [Accepted: 01/24/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND
Acute retinal toxicity has been demonstrated to be associated with the intraoperative use of perfluorocarbon liquids (PFCLs), especially perfluorooctane (PFO). Recently, several cases of PFO-associated blindness have been reported in Spain, Holland, France, Italy, the Middle East, and South America.
METHODS
As a result, a new ISO guideline (ISO 16672:2020) was drafted, discussed, approved, and released in 2019. This recent ISO16672:2020 guideline recommends performing direct cytotoxicity tests as an option along with chemical analysis to measure PFCL quality (purity and safety).
RESULTS
In this review paper, it has been emphasized why an appropriate biological test, specifically direct exposure of PFCL to live cells, for measuring cytotoxicity must be performed with each PFCL batch along with chemical analysis.
CONCLUSIONS
The paper intends to compile all available information to discuss possible approaches for avoiding adverse clinical cases in future.
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