Pneumatic Retinopexy

Pneumatic Retinopexy is an effective surgery for patients suffering from a retinal detachment. In this procedure the retina specialist injects a gas bubble into the vitreous. Typically this is an outpatients procedure in which local anesthetic is used to numb the eye. Your head is positioned so that when the gas bubble rises it will push against the dteached part of the retina. The doctor will then use a freezing probe (cryopexy) or a laser (photocoagulation) to seal the tear in the retina.

The bubble remains for about a week as the eye gradually absorbs the gas. During this time the patient must take care that they position their head and eye so that the gas bubble presses against the detachment. The patient needs to be in this position for about 20 hours a day. For this surgery to be practical the detachment must be in the upper half of the retina. If it were in the lower half the patient would have to be upside down for nearly a week, which is very impractical.

Here are three important things to note about this surgery:

  1. The patient must keep your head and eye in its proper position for a week
  2. The patient must not lie on his back. This will cause the gas bubble to push against the front of the eye and could damage the lens.
  3. The patient must not travel by air or travel to a different altitude. This will cause the gas bubble to expand or contract, changing the intraocular pressure.

There is a variation of this surgery that inserts silicone oil instead of a gas bubble into the eye. A vitrectomy is required to remove the vitreous gel, which is replaced over time. Because the body cannot absorb the oil, a second surgery is usually needed to remove the oil after the detachment has healed. The advantage of this surgery is that the patient has less need to keep their head and eye in the proper position because the oil does not move as readily as the gas bubble would.