Pneumatic retinopexy is an office procedure sometimes used to repair a retinal detachment by injecting a gas bubble into the eye.

Pneumatic retinopexy is one of several surgical procedures that can be used to fix a retinal detachment. The retina is the thin layer of nerve cells that lines the back of the eyeball. The retina functions like the film inside a camera – it receives the image that we see. A retinal detachment causes part of the vision to disappear. Reattaching the retina is necessary to restore the lost area of vision. Surgery to reattach the retina is similar to repairing wallpaper that has come loose from a wall. Patients with a retinal detachment caused by a retinal tear in the upper part of the retina may be candidates for pneumatic retinopexy.

Pneumatic retinopexy is an office procedure that is done under local anesthesia. Patients are able to go home almost immediately after the procedure. Pneumatic retinopexy uses a gas bubble (similar to air) to reattach the retina. The gas bubble is injected into the cavity of the eye (vitreous cavity) where it pushes the retina back into place against the wall of the eye. The detached retina is like wallpaper hanging loose from the wall inside of a room. If a giant balloon was inflated inside the room it could reattach the wallpaper by pushing it against the wall. The gas bubble in the cavity of the eye acts similarly. The bubble always rises toward the ceiling. It may be necessary for the patient to maintain a certain head position as much as possible for several weeks after surgery (for example: right side down) to keep the bubble positioned against the proper area of the retina. The procedure usually involves the use of laser or cryotherapy to form a permanent adhesion (“spot weld”) between the retina and the wall of the eye. The bubble absorbs out of the eye after a period of weeks.

Patients go home after the office procedure. The first postoperative visit takes place the next day. The success of pneumatic retinopexy depends, in part, on maintaining a particular head position after the gas bubble injection. It may be necessary for the patient to keep their head in a certain position (left side down, for example) as much as possible for several weeks after surgery. Some patients notice improvement in vision immediately after surgery, and for others improvement can take several months. Pain can usually be managed with nonprescription pain medications for several days. The recovery period usually lasts several weeks. Most patients do not resume normal activities for at least two weeks. The vision can continue to improve for six months after surgery.

Any surgery has some associated risk. Pneumatic retinopexy has been used since the 1980's. The most frequent side effect is a progression of cataract (only if cataract surgery has not been done already). If a cataract progresses significantly, it may be necessary to have cataract surgery done several months thereafter. Other complications that could occur include infection within the eye, retinal detachment progression, bleeding, and others. Some complications are more serious than others. Fortunately, serious complications are rare. As with any surgery, the surgeon and the patient must weigh the benefits of surgery against the potential risks.