Pneumatic Retinopexy for Retinal Detachment

Surgery Overview

Pneumatic retinopexy is an effective surgery for certain types of retinal detachments. It is usually an outpatient procedure done with local anesthesia.

During pneumatic retinopexy, the eye doctor (ophthalmologist) injects a gas bubble into the middle of the eyeball. Your head is positioned so that the gas bubble floats to the detached area and presses lightly against the detachment. The eye doctor then uses a freezing probe (cryopexy) or laser beam (photocoagulation) to seal the tear in the retina.

The bubble remains for about 1 to 3 weeks to help flatten the retina, until a seal forms between the retina and the wall of the eye. The eye gradually absorbs the gas bubble and the extra fluid that had been in your eye.

What To Expect After Surgery

Recovery from pneumatic retinopexy takes about 3 weeks. The local anesthetic affects only the eye and wears off quickly.

The hardest part of the recovery is keeping the gas bubble in the right place until a seal forms around the tear in the retina.

  • You must keep your head in a certain position for most of the day and night for 1 to 3 weeks after the surgery.
  • You cannot lie on your back or the bubble will move to the front of the eye and press against the lens instead of the retina.
  • Airplane travel is dangerous, because the change in altitude may cause the gas bubble to expand and increase the pressure inside the eye. Avoid air travel until your eye has healed and the bubble is gone.

Contact your doctor right away if you notice any signs of complications after surgery, such as:

  • Decreasing vision.
  • Increasing pain.
  • Increasing redness.
  • Swelling around the eye.
  • Any discharge from the eye.
  • Any new floaters, flashes of light, or changes in your field of vision.

Why It Is Done

The location and size of a tear in the retina determines whether pneumatic retinopexy can be used. Pneumatic retinopexy can be useful when:

  • A single break or tear caused the detachment.
  • Multiple breaks are small and close to each other.
  • The break is in the upper part of the retina.

The break must be in the upper half of the eyeball for pneumatic retinopexy to be practical. You have to be able to position your head so that the break and the bubble are at the highest point. If the break was on the bottom of the eyeball, you would have to stay upside down during your recovery, which would not be practical.

How Well It Works

Pneumatic retinopexy reattaches the retina most of the time.

Chances for good vision after surgery are higher if the macula was still attached before surgery. If the detachment affected the macula, good vision after surgery is still possible but less likely.

Risks

The most frequent problems from pneumatic retinopexy include:

  • Scarring on the retina, called proliferative vitreoretinopathy (PVR), which often causes the retina to detach again. This is the most common cause of failure in surgery for retinal detachment. PVR usually requires additional treatment, including surgery.
  • Formation of new breaks and tears.
  • The need for more than one surgery to reattach the retina.
  • Fluid persisting under the retina or being absorbed only very slowly.
  • Small bubbles of the gas becoming trapped underneath the retina.

Although they do not occur very often, other complications include:

  • The detachment spreading into the macula and affecting central vision.
  • An increase in pressure inside the eye, which can lead to glaucoma.
  • Bleeding in the vitreous gel (vitreous hemorrhage) or under the retina (subretinal hemorrhage). This is very rare.
  • Cataracts may form after surgery.

What To Think About

Pneumatic retinopexy can be done on an outpatient basis.

The success of pneumatic retinopexy depends on keeping the gas bubble against the retina until it flattens. This will require you to hold your head and eye in the proper position for long periods of time. Do not have the procedure if a medical condition or other situation will make you unable to stay in the right position for the time required.

There are a few ways to repair a retinal detachment. The chance that each surgery type can help restore good vision varies from case to case. The cause, location, and type of detachment usually determine which surgery will work best. Other conditions or eye problems may also play a role in the decision.

You may need more than one surgery to reattach the retina if scar tissue from the first surgery grows over the surface of your retina.

Complete the surgery information form (PDF)surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.

Credits

By Healthwise Staff
Primary Medical Reviewer Adam Husney, MD - Family Medicine
Specialist Medical Reviewer Carol L. Karp, MD - Ophthalmology
Current as of July 15, 2013

Current as of: July 15, 2013

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