Orbital Gas after 25-Gauge Pars Plana Vitrectomy with Incorrect Gas Mixture

Abstract We present 2 cases of sutureless 25-gauge pars plana vitrectomy and fluid-gas exchange, in which incorrect gas concentrations likely led to elevated intraocular pressures and retrobulbar gas. Combined removal of orbital gas with anterior orbitotomy and pars plana vitrectomy was performed in...

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Published inCase reports in ophthalmology Vol. 14; no. 1; pp. 301 - 306
Main Authors Ashkenazy, Noy, Danzig, Carl J., Rong, Andrew J., Read, Sarah P., Maeng, Michelle M., Flynn Jr, Harry W., Albini, Thomas A.
Format Journal Article
LanguageEnglish
Published Basel, Switzerland S. Karger AG 01.01.2023
Karger Publishers
Subjects
Case Report
Case reports
Cellulitis
Compartment syndrome
Emergency medical care
Emphysema
Eye surgery
Gases
Glaucoma
Magnetic resonance imaging
Nitrous oxide
orbital decompression
Patients
Retinal detachment
retrobulbar gas
small-gauge pars plana vitrectomy
Surgical outcomes
vitreoretinal surgery
Vitreoretinal surgery
Orbital decompression
Small-gauge pars plana vitrectomy
Retrobulbar gas
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Summary:Abstract We present 2 cases of sutureless 25-gauge pars plana vitrectomy and fluid-gas exchange, in which incorrect gas concentrations likely led to elevated intraocular pressures and retrobulbar gas. Combined removal of orbital gas with anterior orbitotomy and pars plana vitrectomy was performed in the first case to address expanding intraocular and retrobulbar gas resulting from a suspected error in gas dilution. Vitreous and orbital gas removal by needling was effective in the second case. In patients with elevated intraocular pressure and orbital gas accumulation after vitrectomy, combined intraocular and orbital decompressions were effective in optimizing clinical outcomes. There is no consensus regarding the best management of orbital gas after vitrectomy. We propose that a multidisciplinary technique should be considered, when available.
ISSN:1663-2699
1663-2699
DOI:10.1159/000530401