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Ophthalmic Images
November 12, 2020

Gas Bubbles in the Anterior Chamber

Author Affiliations
  • 1Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
JAMA Ophthalmol. 2020;138(11):e202049. doi:10.1001/jamaophthalmol.2020.2049

A 44-year-old man with a history of scleral buckling for rhegmatogenous retinal detachment and a tic disorder with continuous movement of the head underwent pars plana vitrectomy with lensectomy and injection of octafluoropropane (C3F8) gas, 12%, for recurrent rhegmatogenous retinal detachment in the right eye. He was instructed to remain in a left lateral position after surgery. One week later, a slitlamp examination of the right eye demonstrated C3F8 gas bubbles resembling fish eggs in the anterior chamber, with an increase of intraocular pressure to 40 mm Hg (Figure). He started receiving once-daily treatment with topical carteolol hydrochloride, 2%, and the intraocular pressure subsequently decreased, with resolution of the gas bubbles 3 weeks after surgery. We postulated that continuous movement of the head caused the injected gas to take the form of tiny bubbles, which led to gas leaking into the anterior chamber, which in turn blocked aqueous humor outflow, resulting in the intraocular pressure elevation.

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