Retinal Detachment Repair
Pneumatic Retinopexy (Gas Bubble Injection)
Cryotherapy or laser treatment is performed to seal the retinal tear. The surgeon, using a needle, injects a gas bubble inside the vitreous cavity of the eye. The patient is instructed to keep his head in a specific position so that the gas bubble pushes the detached retina against the back wall of the eye to seal the retinal tear. The patient is asked to remain in this position for various periods of time until the retinal tear is sealed against the back wall of the eye. The surgeon will tell you how long special positioning is necessary.
The gas bubble in the vitreous cavity of the eye expands for several days and takes six to eight weeks to disappear. During this time, airplane travel or travel to a high altitude must be avoided because high altitudes can result in an expansion of gas and an increase in pressure that can damage the eye. Your surgeon will tell you when it is safe to travel. It is also important for a patient with a gas bubble not to lie face up, as the air bubble may come to rest against the lens of the eye and cause a cataract or high pressure in the eye.
Outcome
The chance of successfully reattaching the retina with pneumatic retinopexy is less than with the scleral buckling surgery, but the final visual outcome is better if the pneumatic retinopexy is successful. Also, pneumatic retinopexy cannot be used, or is not effective, for every retinal detachment. The surgeon will discuss with you whether pneumatic retinopexy is feasible and the chances for successfully reattaching your retina. With pneumatic retinopexy, hospitalization, general anesthesia, and the cutting done for the scleral buckling surgery are all avoided. Complications of pneumatic retinopexy include cataract formation, glaucoma, gas getting under the retina, excessive scar tissue formation, and infection. Any one of these complications can lead to a total loss of vision, but each is rare. The most common complication is recurrence of the retinal detachment. The recurrence rate is about 25%. If the retina becomes detached again, scleral buckling surgery or vitrectomy can usually be performed to reattach it.
