What Is a Pneumatic Retinopexy?

Pneumatic retinopexy is one of the surgical treatments to repair a detached retina and restore vision.

Pneumatic retinopexy is one of the surgical treatments to repair a detached retina and restore vision. The procedure is usually done by injecting a gas bubble into the eye.

A pneumatic retinopexy is usually done on an outpatient basis under local anesthesia:

• In this procedure, an ophthalmologist usually injects a gas bubble into the middle of the eye.
• Repairing the retinal detachment may require softening the eye by withdrawing a small amount of fluid from the space between the clear dome at the front of the eye (cornea) and the colored part of the eye (iris).
• A patient’s head may be appropriately positioned so that the injected bubble floats to the detached area and presses against the detachment.
• Either at the time of the procedure or a few days later, the ophthalmologist seals the tear in the retina using a freezing probe or laser beam. With no new fluid passing through the retinal tear, the fluid that had previously been collected under the retina is absorbed, and the retina is able to reattach itself to the back wall of the eye.
• The bubble helps to flatten the retina until a seal forms between the retina and the wall of the eye. 
• The ophthalmologist may also apply an antibiotic ointment to the eye to prevent any infection. Then, the patient’s eye may be patched or covered for a few days.
• The patient may notice a red puffy and teary eye. The doctor may reassure the patient and prescribe antibiotics, steroid eye drops, and painkillers after the procedure.
• The patient may be allowed to go home once the procedure is completed; however, certain precautions may be recommended.
• The eye may usually recover within a few weeks and the bubble may be absorbed into the eye subsequently.
• Pneumatic retinopexy may be typically completed within an hour in the outpatient setting.

What are the common precautions after pneumatic retinopexy?

Common precautions after the procedure include:

• Patients may be recommended to keep their head in a certain position for 3 weeks, depending on the recovery. To ensure that the retina reattaches properly and depending on the location of the retinal tears, patients may have to spend a significant amount of time each day in a facedown position to keep the bubble in the correct position.
• They may be recommended not to lie on their back as the bubble will move to the front of the eye and press against the lens instead of the retina. Until the gas bubble disappears, patients may also position pillows in the bed in a way that keeps them from lying on their back.
• They may be advised against air travel until the eye has healed. A change in altitude could cause the gas bubble to expand. This would increase the pressure inside the eye.
• Patients will need to wear protective eyewear for some time after the surgery as well.
• Patients may be advised to take pain medications and antibiotics for a few weeks depending on their age and recovery.

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What is the recovery period after pneumatic retinopexy?

The success of pneumatic retinopexy depends on maintaining the head position after the gas bubble injection. Some patients notice an improvement in vision immediately after surgery, and for others, improvement can take several months. The recovery period usually lasts several weeks (at least 4 weeks). Most patients do not resume normal activities for at least 2 weeks. The vision may continue to improve for 6 months after surgery.

What are the possible complications of pneumatic retinopexy?

Pneumatic retinopexy is a minimally invasive procedure and usually does not have complications, but as with any procedure, a few common complications may be expected, which include:

• Surgery related complications like pain, infection, and bleeding
• The most common complication is a recurrence of the detachment
• The other common complication is the cataract formation (a condition in which the lens of the eye may become opaque, resulting in blurred vision)
• An increase in the eye pressure may damage the optic nerve and cause glaucoma
• Gas may get under the retina if the head position is not maintained
• Excessive scar tissue formation
• Cystoid macular edema: A condition where there is swelling in the central part of the retina. This may cause permanent loss of vision due to the scarring of the retina.
• More serious but a rare complication includes vision loss. Approximately, there is a 20% chance of needing further procedures to save the eye and the vision.

Is pneumatic retinopexy the best treatment to reattach a retina?

Pneumatic retinopexy is not usually the best or the only treatment to reattach a retina. This procedure is usually used for uncomplicated detachment with the tear located in the upper half of the retina. However, it is usually not recommended for a complicated retinal detachment. Compared to other retinal surgeries, this surgery has a lower single surgery success rate.