Responses

Download PDFPDF
Acute retinal toxicity associated with a mixture of perfluorooctane and perfluorohexyloctane: failure of another indirect cytotoxicity analysis
Compose Response

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Statement of Competing Interests

PLEASE NOTE:

  • A rapid response is a moderated but not peer reviewed online response to a published article in a BMJ journal; it will not receive a DOI and will not be indexed unless it is also republished as a Letter, Correspondence or as other content. Find out more about rapid responses.
  • We intend to post all responses which are approved by the Editor, within 14 days (BMJ Journals) or 24 hours (The BMJ), however timeframes cannot be guaranteed. Responses must comply with our requirements and should contribute substantially to the topic, but it is at our absolute discretion whether we publish a response, and we reserve the right to edit or remove responses before and after publication and also republish some or all in other BMJ publications, including third party local editions in other countries and languages
  • Our requirements are stated in our rapid response terms and conditions and must be read. These include ensuring that: i) you do not include any illustrative content including tables and graphs, ii) you do not include any information that includes specifics about any patients,iii) you do not include any original data, unless it has already been published in a peer reviewed journal and you have included a reference, iv) your response is lawful, not defamatory, original and accurate, v) you declare any competing interests, vi) you understand that your name and other personal details set out in our rapid response terms and conditions will be published with any responses we publish and vii) you understand that once a response is published, we may continue to publish your response and/or edit or remove it in the future.
  • By submitting this rapid response you are agreeing to our terms and conditions for rapid responses and understand that your personal data will be processed in accordance with those terms and our privacy notice.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

Other responses

Jump to comment:

  • Jose C. Pastor, Girish K. Srivastava, Ivan Fernandez-Bueno, Cristina Andrés-Iglesias, Jesús Medina, Fernando Rull, Antonio Dueñas and Rosa M. Coco
    Published on:
  • Yalcin Karakucuk, Berker Bakbak and Saban Gonul
    Published on:
  • Published on:
    Letter to Editor
    • Jose C. Pastor, Professor and Ophthalmologist Instituto Universitario de Oftalmobiología Aplicada (IOBA), Eye Institute, University of Valladolid, Valladolid, Spain
    • Other Contributors:
      • Girish K. Srivastava, Principal Investigator
      • Ivan Fernandez-Bueno, Principal Investigator
      • Cristina Andrés-Iglesias, Post doc
      • Jesús Medina, Professor
      • Fernando Rull, Professor
      • Antonio Dueñas, Professor
      • Rosa M. Coco, Professor

    We have read with great interest the e-letter from Karakucuk et al. published in BJO responding to our paper titled ‘Acute retinal toxicity associated with a mixture of perfluorooctane and perfluorohexyloctane: Failure of another indirect cytotoxicity analysis ’ and we appreciate their positive appreciation of our research work.
    We consider extraordinarily important that they have reported four more cases in their country, thus, supporting that acute toxicity cases were not a Spanish problem as has been stated by some retinologist at an European congress (Barcelona, September 2017).
    We believe that this letter should encourage other colleagues from other countries from all over the world to report cases that certainly exist, according to non-official information from several companies.
    We completely agree that the ISO (the International Organization for Standardization) guidelines to determine the in vitro cytotoxicity of intraocular medical devices should be immediately changed. These guidelines should adopt direct cytotoxicity methods to be performed with finished, sterilized, and ready for release products. The analytical method utilized should include cells or tissues close to those of the retina to guarantee specific sensitivity and should be scientifically validated.
    We support the suggestion of increasing chemical research, because some companies are promoting chemical tests, as a “safety guarantee”, whose scientific validity and their direct...

    Show More
    Conflict of Interest:
    None declared.
  • Published on:
    Letter to Editor
    • Yalcin Karakucuk, Doctor Selcuk Universitesi opthalmology Selcuk university faculty of medicine Konya
    • Other Contributors:
      • Berker Bakbak, Doctor
      • Saban Gonul, Doctor

    Dear Editor:

    We read the article ‘Acute retinal toxicity associated with a mixture of perfluorooctane and perfluorohexyloctane: Failure of another indirect cytotoxicity analysis ’ by Coco et al. with great interest.[1] In this study, the authors reported on ocular toxicity due to perfluorooctane (PFO). They advised that the protocols used to determine the cytotoxicity of intraocular medical devices (which have been approved by the Organisation for the Standardisation of International Standards based on indirect methods) should be revised to ensure safety. We congratulate Coco et al.1 for their report because we believe that it has the potential to be a significant contribut or to the literature on this topic.

    As is commonly known, PFO is saturated with PFO liquids, which have highly stable carbon-fluorine bonds that consequently make them inert. PFO has highly specific gravity, low viscosity, optical clarity immiscibility in water and interface tension towards water. It is regularly used in vitreoretinal surgery for complex retinal detachment repair because it displaces subretinal fluid and blood anteriorly, unfolds the retina in giant retinal tear cases and provides counter traction and retinal stabilisation during membrane peeling in eyes with proliferative vitreoretinopathy.[2,3] These properties make PFO useful for intraocular surgery. However, some limitations exist regarding PFO use as a long- term tamponade such as amaurosis, a lack of light perce...

    Show More
    Conflict of Interest:
    None declared.