Pneumatic retinopexy is an effective
surgery for certain types of
retinal detachments . It uses a bubble of gas to push
retina against the wall of the eye, allowing fluid to
be pumped out from beneath the retina. It is usually an
outpatient procedure done with
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
bubble flattens the retina so that the fluid can be pumped out from beneath it.
The eye doctor then uses a freezing probe (cryopexy) or laser
beam (photocoagulation) to seal the tear in the
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.
variation of this surgery uses a large bubble of silicone oil instead of a gas
bubble to close and flatten the retina. A vitrectomy procedure, in which the
vitreous gel is removed, is required to inject
silicone oil. Because the silicone oil cannot be absorbed, a second procedure
is needed to remove the oil after the retinal detachment has healed.
What To Expect After Surgery
Recovery from pneumatic retinopexy
takes about 3 weeks. The local anesthetic affects only the eye and wears off
The hardest part of the recovery is keeping the gas
bubble in the right place until a seal forms around the tear in the
- You must keep your head and eye in the proper
position for 16 to 21 hours a day for 1 to 3 weeks after the
- You cannot lie on your back or the bubble will move to the
front of the eye and press against the
- Airplane travel is dangerous,
because the change in altitude may cause the gas bubble to expand and increase
the pressure inside the eye.
When silicone oil is used instead of gas, there may be less
need to keep your head and eye in a precise position, because the oil bubble
does not move as readily as a gas bubble. This may make the surgery and
recovery easier for older adults, young children, and anyone who may have
trouble keeping his or her head and eye in the proper position.
Contact your doctor right away if you notice any signs of
complications after surgery, such as:
- Decreasing vision.
- Increasing redness.
- Swelling around the
- Any discharge from the eye.
- Any new
flashes of light, or changes in your field of
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
- Multiple breaks are small and close to each
- 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
A single treatment with pneumatic
retinopexy reattaches the retina most of the time. With additional treatments
such as vitrectomy or scleral buckling, the surgery is successful nearly all
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
The most frequent problems from pneumatic
- 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. This is much more common with pneumatic retinopexy than with scleral
- Fluid persisting under the retina or being absorbed only
- Small bubbles of the gas becoming trapped underneath the
Although they do not occur very often, other complications
- The detachment spreading into the
macula and affecting
- An increase in pressure
inside the eye (glaucoma).
- Detachment of the choroid, the
middle layer of tissue that forms the eyeball. Choroidal detachment occurs in a
small number of people who have pneumatic retinopexy, and it usually heals on
its own without further treatment.
- Bleeding in the
vitreous gel (vitreous hemorrhage) or under the retina
(subretinal hemorrhage). This is very rare.
What To Think About
Pneumatic retinopexy can be
done on an
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
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)(What is a PDF document?) to help you prepare for this surgery.
|Primary Medical Reviewer||Adam Husney, MD - Family Medicine|
|Specialist Medical Reviewer||Carol L. Karp, MD - Ophthalmology|
|Last Revised||August 7, 2011|