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

Noy Ashkenazy; Carl J. Danzig; Andrew J. Rong; Sarah P. Read; Michelle M. Maeng; Harry W. Flynn; Thomas A. Albini

doi:10.1159/000530401

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

Noy Ashkenazy, Carl J. Danzig, Andrew J. Rong, Sarah P. Read, Michelle M. Maeng, Harry W. Flynn, Thomas A. Albini

Research output: Contribution to journal › Article › peer-review

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.

Original language	English (US)
Pages (from-to)	301-306
Number of pages	6
Journal	Case Reports in Ophthalmology
Volume	14
Issue number	1
DOIs	https://doi.org/10.1159/000530401
State	Published - Jul 10 2023

Keywords

Orbital decompression
Retrobulbar gas
Small-gauge pars plana vitrectomy
Vitreoretinal surgery

ASJC Scopus subject areas

Ophthalmology

Access to Document

10.1159/000530401

Cite this

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title = "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 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.",

keywords = "Orbital decompression, Retrobulbar gas, Small-gauge pars plana vitrectomy, Vitreoretinal surgery",

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AU - Ashkenazy, Noy

AU - Danzig, Carl J.

AU - Rong, Andrew J.

AU - Read, Sarah P.

AU - Maeng, Michelle M.

AU - Flynn, Harry W.

AU - Albini, Thomas A.

PY - 2023/7/10

Y1 - 2023/7/10

N2 - 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.

AB - 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.

KW - Orbital decompression

KW - Retrobulbar gas

KW - Small-gauge pars plana vitrectomy

KW - Vitreoretinal surgery

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

Abstract

Keywords

ASJC Scopus subject areas

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