Pneumatic retinopexy is one option for treating retinal detachment. Typically it is considered when there is one retinal tear in the upper half of the retina. It can also be used if there is more than one tear, provided the tears are very close to each other. Usually the retinal detachment also needs to be of very recent onset. In the event you have a retinal detachment, your retinal specialist will examine your eye and determine if this procedure is right for you.
During this procedure, Dr. Mitchell injects a small gas bubble into the back of the eye. The gas bubble then expands and pushes the retina back in place. Once the retina is reattached, laser retinopexy or cryotherapy is applied around the retinal tear(s), causing a scar to form that holds the retina in place permanently. This part of the procedure may happen on the same day or a few days after the bubble is placed inside the eye. Unlike scleral buckling or vitrectomy surgery (the other two major options for retinal detachment repair), pneumatic retinopexy is performed in the office and does not require a trip to the operating room.
Positioning after pneumatic retinopexy is critical to the success of the procedure. The gas bubble needs to be pushing against the retina and closing the retinal tear, and this usually requires the patient to maintain a face down position after the procedure. Depending on the exact location of the tear, the positioning will vary and your retinal specialist will give clear individualized instructions for positioning on a case by case basis. The positioning after pneumatic retinopexy and other retinal procedures is a challenging part of the process, but plays a large part in determining the success of many of these procedures. Typically the positioning needs to be maintained for 10 to 14 days after the procedure.
The gas bubble eventually is absorbed into the blood stream and is replaced in the eye by clear fluid. Until the bubble resolves it is very important that patients do not fly or experience significant changes in altitude. The change in altitude causes gas to expand, which increases the pressure in the eye causing irreversible damage. It is also important that any other physicians or dentists providing treatment are made aware that there is a gas bubble in your eye. Certain other medications, particularly inhaled anesthetics can also cause expansion of the gas bubble and increased eye pressure. Your retinal specialist will let you know when the gas bubble has resolved and it is safe to travel by air.