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Observation
July 2016

Chronically Retained Intraocular Air

Author Affiliations
  • 1Ophthalmic Consultants of Boston, Boston, Massachusetts
JAMA Ophthalmol. 2016;134(7):842-843. doi:10.1001/jamaophthalmol.2016.1178

Intravitreal air is typically absorbed into the bloodstream through the retinal vasculature. We present a case where, in the setting of cyclophotocoagulation, low intraocular pressure, and multiple surgical procedures, air remained in the globe. Eventually, surgery was required to remove the air and allow the patient to travel at high altitudes.

We present a case of chronically retained air within the vitreous cavity. The patient was a man in his 50s who months after retina surgery reported severe pain in his left eye whenever he was 1200 m above sea level. The patient had a remote history of Acanthamoeba keratitis for which he had undergone 4 penetrating keratoplasties in the left eye. He also developed secondary glaucoma and underwent the placement of 2 glaucoma drainage devices and 4 diode laser treatments. He then sustained trauma to the left eye and dehiscence of his failed corneal graft. The graft was repaired, but 2 weeks later, he developed a funnel retinal detachment. He then underwent an endoscopic pars plana vitrectomy with attempted retinal detachment repair. The funnel was unable to be opened owing to severe proliferative vitreoretinopathy. At the conclusion of this case, an air fluid exchange was performed.

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