Blindness after ophthalmic surgery

The injection of gas into the eye, as is performed in various ophthalmic surgical procedures, can cause blindness by expanding the eye.

This rare but serious problem is described by a team of anesthesiologists and ophthalmologists from the Essen (Germany) University Clinic in the current issue of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2008; 105(6): 108-12).

Ophthalmologists inject gas into the eye mainly during the surgical treatment of retinal hemorrhages or injuries. The purpose of the gas is to help press the detached retina to the wall of the eye. There is a risk of subsequent expansion of the gas bubble during airplane travel, at high altitudes, or under nitrous oxide anesthesia. This expansion can damage the retinal vessels, and the risk remains present for weeks after the surgical procedure.

In order to avoid this problem, ophthalmologists must inform patients before any operation of this type about the possibly dramatic consequences of air travel, travel to high altitudes, and nitrous oxide (laughing gas) anesthesia. If in doubt, the anesthesiologist should avoid nitrous oxide, in particular in unconscious patients. Three months after an intraocular gas injection there should be no risk for the eye deriving from the remaining gas bubble.