Severe emulsification after combined use of a partially fluorinated alkane and silicone oil

Purpose: To present a case with accidental incomplete removal of a partially fluorinated alkane during a direct exchange with silicone oil and a subsequent severe emulsification of the silicone oil. Case report: During a macular rotation procedure an incomplete exchange of perfluorohexylhexane (F6H6) with silicone oil occurred. Initial postoperative findings showed phase separation and exact visualization of the fundus. After a few days severe. opacification of the mixture occurred, markedly reducing fundus visibility. The substances were removed immediately and analyzed by gas chromatography. Conclusion: The direct exchange between silicone oil and partially fluorinated alkane should be avoided. Their combined use as a simultaneous endotamponade can cause opaque separation.