What is pneumatic retinopexy?

Pneumatic retinopexy is a procedure to fix a detached retina and restore vision. Unlike other procedures to treat a detached retina, it often takes place in an office setting.

The retina is a layer of cells that line the back of your eye. These cells use light to send visual information to your brain. Retinal detachment happens when part or all of your retina detaches from the inner wall of the eye. When that happens, your retina doesn't work normally. If not treated quickly, a retinal detachment can cause permanent vision loss.

If you have pneumatic retinopexy, your eye care provider will inject an expanding gas bubble into your eye. They will position you so that the bubble floats over the detached area and pushes it against the back of your eye. Your eye care provider also uses a freezing device or a laser to seal the retina against the wall of the eye.

Why might I need pneumatic retinopexy?

Certain factors make it more likely that you will have a retinal detachment. These include:

• Nearsightedness

• Other eye disorders, such as uveitis

• Past cataract surgery

• Being older

Most of the time, the retinal detachment happens suddenly on its own. But in rare cases, an eye injury can cause it.

If you have retinal detachment, you will likely need surgery. You might have an increase in floaters in your eye. These look like little specks or cobwebs that float in your field of vision. These floaters can be so dense that they impair your vision. You might also have light flashes in your eye. You may have a curtain over your field of vision.

If you have these symptoms, you may need a procedure to reattach your retina. This can restore vision.

Eye care providers sometimes treat retinal detachment with scleral buckling, vitrectomy, or a combination of the two. Pneumatic retinopexy is a less invasive choice. It may also have a slightly lower risk of complications. This procedure may not be right for you if you have a complex retinal detachment. Or if your tear is on the lower part of your eye. Ask your eye care provider about the benefits and risks of all of your treatment options.

What are the risks of pneumatic retinopexy?

Most people do well with this procedure. But complications can sometimes occur. Your risks may depend on your age, your health conditions, and your specific retinal detachment. More common risks of the procedure include:

• A scar-like process on the retina that can lead to detachment happening again (proliferative vitreoretinopathy)

• The detached retina is not fixed or happens again

• Trapped gas in your eye

Some of the less common risks are:

• Folds in your retina

• Eye inflammation

• Increased eye pressure

• Bleeding in your eye

• Detachment of the layer under your retina (the choroid)

• New retinal tear

There is also a risk that the retina will detach again and that you will need another procedure.

How do I get ready for pneumatic retinopexy?

Ask your eye care provider what you need to do to get ready for pneumatic retinopexy. Ask if you need to stop taking any medicines before the procedure. Follow any directions you are given for not eating or drinking before the procedure.

Your eye care provider may want to use special tools to shine a light in your eye and check your retina. You will need to have your eyes dilated for the eye exam.

What happens during pneumatic retinopexy?

Talk with your eye care provider about what to expect during your procedure. You will likely have pneumatic retinopexy at your provider’s office. In general, during the procedure:

• You may be given a medicine to help you relax. But you will be awake.

• Your eye care provider will give you eye drops to dilate your eye. You’ll also get eye drops to make the area numb.

• Your eye care provider may inject another anesthetic around your eye.

• Your eye care provider may use a syringe to remove some fluid from inside your eye. This is to reduce the pressure in your eye.

• Your eye care provider will inject a bubble into the eye. Your provider may use a tool with a light (ophthalmoscope) to make sure the bubble is in the right place.

• Your eye care provider may use a freezing tool or a laser to help seal the retina against the wall of the eye.

• Your eye care provider may apply an antibiotic ointment to your eye. This will help prevent infection.

• Your eye care provider may patch and cover your eye.

What happens after pneumatic retinopexy?

Ask your eye care provider what you should expect after your procedure. Plan to have someone drive you home. Someone should stay with you after the procedure.

Follow your eye care provider’s instructions about eye care. You may need to take eye drops with antibiotics to help prevent infection. Your eye may be a little sore after the procedure. But you should be able to take over-the-counter pain medicines. You may need to wear an eye patch for a day or so.

Your eye care provider will give you specific instructions about how to position your head after the procedure. It's important to follow all your eye care provider’s instructions to help reduce the chance of complications. You may need to keep in a certain position for 8 hours or more after your procedure. To prevent complications, you will also need to avoid air travel until the bubble is gone. Ask your eye care provider when it will be safe for you to fly again.

You will need close follow-up care with your eye care provider to see if the procedure was effective. You may have a scheduled appointment the day after the procedure. Tell your provider right away if you have decreasing vision or increasing pain or swelling around your eye. If the procedure doesn’t work, you may need to have surgery.

Next steps

Before you agree to the test or the procedure, make sure you know:

• The name of the test or procedure

• The reason you are having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• What the possible side effects or complications are

• When and where you are to have the test or procedure

• Who will do the test or procedure and what that person’s qualifications are

• What would happen if you did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how you will get the results

• Who to call after the test or procedure if you have questions or problems

• How much you will have to pay for the test or procedure