During vitreoretinal surgery, perfluorocarbon liquid (PFCL) is introduced. Which property of PFCL makes it suitable as an intraoperative tool to unfold a giant retinal tear?

• A High surface tension with water
• B Optical clarity and low refractive index
• C Miscibility with silicone oil
• D High specific gravity (>1.7 g/mL) causing it to sink and flatten the posterior retina ✓

Explanation

Perfluorocarbon liquids (e.g., perfluorodecalin) have a high specific gravity (approximately 1.76–1.94 g/mL), which is heavier than water and vitreous. When injected into the vitreous cavity, PFCL sinks to the posterior pole, mechanically flattening the posterior retina and stabilizing giant retinal tears by preventing posterior roll-over during fluid-air exchange. High surface tension with water would describe silicone oil, not PFCL. PFCL is immiscible with silicone oil, which is actually exploited for PFCL-silicone oil exchange.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.