Pneumatic Retinopexy

Pneumatic retinopexy is a procedure that can be used to repair a detached retina. The retina is the thin membrane that covers the back of the eye. It sends vision signals along the optic nerve to the brain, allowing you to see. A detached retina happens when the retina separates (detaches) from the back wall of the eyeball.

Pneumatic retinopexy may be done to reattach the retina and prevent vision loss. This procedure is used in cases where the detachment is small and located near the top of the eye. During the procedure, a gas bubble is injected into the back of the eye to move the retina back into proper position. Then either a laser (photocoagulation) or a freezing probe (cryopexy) is used to secure the retina in place.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to other structures or organs.
• Increased eye pressure.
• Failure of the procedure.

What happens before the procedure?

• You may have an eye exam, blood tests, and imaging tests.
• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
  • Taking over-the-counter medicines, vitamins, herbs, and supplements.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay healing after the procedure. If you need help quitting, ask your health care provider.
• Plan to have someone take you home from the hospital or clinic.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.

What happens during the procedure?

• An IV may be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb your eye (local anesthetic).
• Eye drops may be placed in your eye to enlarge (dilate) your pupil. This will allow your health care provider to see inside your eye.
• An instrument that holds your eye open (lid speculum) will be placed on your eye.
• Your surgeon will inspect your retina by looking through your eye with an eye scope.
• A gas bubble will be injected into your eye to hold your retina in position.
• The tears in your retina will usually be repaired using one of these methods:
  • Photocoagulation. This involves using a laser to apply light energy in order to reattach the retina with small burns.
  • Cryopexy. This involves using a freezing probe to reattach the retina.
• Antibiotic drops or ointment may be placed in your eye.
• A protective covering (eye patch or eye shield) may be placed over your eye.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• You may have an eye patch or eye shield over your eye. Your health care provider will tell you when to remove it.
• You will be given instructions about how to position your head to keep the gas bubble against your retina. Your health care provider will also let you know how long you have to keep doing this.
  • Usually, you will need to keep your head in the specified position for about 16 hours a day with 15-minute breaks each hour for at least 5 days.
  • Follow your health care provider’s instructions exactly because proper head positioning after surgery is very important to the success of the procedure.
• You may be given pain medicine as needed.
• Your blood pressure, heart rate, breathing rate, and blood oxygen level may be monitored until you leave the hospital or clinic.
• Do not drive until your health care provider approves.

Summary

• Pneumatic retinopexy is a procedure that can be used in certain cases to repair a detached retina.
• After the procedure, follow your health care provider’s instructions about how to position your head and how long you need to hold the position. You will need to do this for many hours a day. Proper head positioning during this time is very important to the success of the procedure.
• You may have an eye patch or eye shield over your eye after the procedure. Your health care provider will tell you when to remove it.
• When this procedure is unsuccessful, additional surgery may be required.

Pneumatic Retinopexy, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, you may have:

• Eye soreness.
• Eye irritation.
• General discomfort from having to hold your head in a certain position for long periods of time.

Follow these instructions at home:

Safety

• Follow instructions from your health care provider about how to position your head. This is important for healing. Your head position and how long you have to hold the position depend on the type of retinal detachment you had.

Medicines

• Use eye drops and ointments as told by your health care provider. Do not stop using these eye medicines even if you start to feel better.
• Take over-the-counter and prescription medicines only as told by your health care provider.

Driving

• Do not drive or use heavy machinery until your health care provider approves.
• Do not drive for 24 hours if you were given a medicine to help you relax (sedative) during your procedure.

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe.
• Do not fly in an airplane or go to high altitudes until your health care provider says it is safe for you.

General instructions

• Wear your eye patch or eye shield as told by your health care provider. Remove it only as told.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay healing after the procedure. If you need help quitting, ask your health care provider.
• Wear sunglasses during the day.
• Do not wear eye makeup or contact lenses until your health care provider approves.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have more redness, swelling, or pain in your eye.
• You have a fever or chills.
• You have fluid, blood, or pus coming from your eye.
• You have an increase in eye discharge.
• Your vision gets worse.
• You have floaters, see bright flashes of light, or have a shadow or partial blindness in part of your field of vision.
• You cannot keep your head in one position for recovery.

Get help right away if you have:

• Severe eye pain.
• Sudden loss of vision.

Summary

• Follow instructions from your health care provider about how to position your head. This is important for healing.
• Wear your eye patch or eye shield as told by your health care provider. Remove it only as told.
• Contact a health care provider if you have any changes in your vision.