Author Affiliations: Department of Ophthalmology, University of Louisville School of Medicine, Louisville Kentucky.
The recent case series by Lim and colleagues1 reviews 3 cases from the anesthesia literature that describe possible venous air embolism (VAE) occurring with air/fluid exchange during vitreoretinal surgery. In an article by Ruest et al,2 fluid gas exchange was performed at the end of surgery, but they do not imply that a high pressure was used. Venous air embolism was suspected but not confirmed by auscultation or other tests. They hypothesized that VAE occurred by air entering the systemic circulation through the central retinal vein, which has a diameter of 300 μm.
El-Annan J, Barr CC. Does Venous Air Embolism Occur During Air/Fluid Exchange?. Arch Ophthalmol. 2011;129(9):1244-1245. doi:10.1001/archophthalmol.2011.237