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2.9与t-PA联合应用治疗黄斑下出血[45] 老年性黄斑变性黄斑出血，在玻璃体切除后，黄斑下积血可以用t-PA液化，再用氟碳液体将积血挤入玻璃体腔后吸除。
2.10其他 氟碳液体在严重增殖性糖尿病视网膜病变[46]，脉络膜缺损视网膜脱离[47]，视网膜多发裂孔[48]，视网膜劈裂[49]，眼球内异物[50]，中心浆液性视网膜脉络膜病变引起的大泡性视网膜脱离[51]，人工角膜视网膜脱离[52]，脉络膜肿瘤切除[53]，去除视网膜下气体[54]，黄斑转位[55]等手术中也有成功应用。
2.11氟碳液体在眼内的B超，CT，MRI图像[56-58] 氟碳液体在手术后可以存留眼内，B超图像显示氟碳液体位于眼球最低位置，氟碳液体内部为一无回声区，表面为回声增强线，氟碳液体后有一串类似金属异物的伪像。氟碳液体在CT中显示不透光影，可以显示氟碳在眼内的分布。氟碳液体在眼内MRI检查T1W,T2W显示显著低信号，无法评价视网膜。
2.12氟碳液体临床应用选择，眼内保留时间及并发症 动物实验已证实仅含氟碳原子的氟碳液体如全氟菲（Perfluorophenanthrene）比含氧氮原子的氟碳液体如全氟三丁胺（Perfluorotributylamine）眼内耐受好，选择毫无疑义。有文献比较了临床常用的全氟辛烷（Perfluorooctane）与脱氢全氟菲[59,60]（Perfluoroperhydrophenanthrene）临床应用结果，全氟辛烷屈光指数1.27，蒸发压52mmHg,粘度0.69centistoke,脱氢全氟菲屈光指数1.33（与生理盐水和房水极近似），蒸发压<1mmHg,粘度8.3centistoke,全氟辛烷与生理盐水的屈光指数区别、高蒸发压、低粘度使其在临床手术过程中更容易取干净。术后角膜异常，眼压升高的发生率比脱氢全氟菲低，但两者应用后视网膜复位率无显著差异。为提高脱氢全氟菲的表面能见度，Liang等[61]将全氟辛烷与全氟脱氢菲按不同比例混合，改变屈光指数后使用。术中使用氟碳液体并发症主要为氟碳液体进入视网膜下，大多数文献认为后极部大裂孔不能使用氟碳液体，全氟菲18dynes/cm的表面张力可以阻止其从小于0.5视盘直径的裂孔进入视网膜下[37,62-64]，Han 等[65]报道，在视网膜切除，切开后只要解除所有的视网膜牵引，氟碳液体注入可以超过视网膜切开的后缘，19例患者只有１例发生氟碳液体进入视网膜下。一旦氟碳液体进入视网膜下，除从原视网膜裂孔吸除外还可以作后极部视网膜切开引流。文献报道视网膜下残留的氟碳液体[66-69]可以用39号弹性管道在氟碳液体旁切开，将管道伸入氟碳液体泡内吸除，术后视力得到提高。文献均认为氟碳液体在眼内保留一段时间可引起视网膜，角膜内皮损害，仍有将氟碳液体在手术后留在眼内作眼内填充，待视网膜与色素上皮形成粘连。Tanji等[70]报道将脱氢全氟菲在患者眼内保留了3d～9wk（平均3.3wk），Blinder 等[71]将全氟菲在患者眼内保留了5d～４wk，术后保持坐位或仰卧位，取得满意临床效果。并发症为白内障，视网膜脱离复发,PVR复发，低眼压，黄斑皱折，高眼压，前房渗出，发生率与其他玻璃体手术硅油填充后相似。有个案报道[72]残留氟碳液体在眼内可引起巨细胞炎症反应。
3小结
重水（氟碳液体）以它特殊的物理、化学特点，作为流体动力操作工具（hydrokinetic manipulation tool）在玻璃体视网膜手术中应用，极大的方便了玻璃体视网膜手术，提高手术成功率。临床效果得到时间的检验，甚至有文献[73]建议玻璃体切割时用氟碳液体作灌注液。但氟碳液体作为玻璃体替代物不能像硅油那样在玻璃体腔内长期保留。
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