Medically reviewed by Dr. Niranjana Bejan Singh. Written to established clinical-education standards (AAO/Mayo/NHS/NEI) and adapted for this hospital. Not a substitute for professional medical advice.
Pneumatic retinopexy is a less invasive, in-office alternative to surgical retinal detachment repair, used for certain uncomplicated detachments. A small bubble of gas is injected into the vitreous cavity of the eye; the bubble floats up against the retinal tear and gently presses it closed against the eye wall, allowing the fluid under the retina to be reabsorbed naturally. The tear itself is sealed separately with laser or cryotherapy, either just before or after the gas injection.
Who typically needs this
- Best suited for retinal detachment caused by a single tear, or a small group of tears, located in the upper part of the retina.
- Requires that the patient can reliably maintain specific head positioning for several days.
- Not typically suitable for detachments with multiple tears in different locations, tears in the lower retina, or significant scar tissue.
- Chosen when the retina specialist judges the detachment's characteristics are favorable for this less invasive approach.
What to expect
- Performed in the clinic under local anesthetic eye drops, without an operating room in most cases.
- The retinal tear is sealed with laser or a freezing probe (cryotherapy).
- A small bubble of gas is injected into the vitreous cavity using a fine needle.
- The patient is instructed to hold a specific head position, often for much of the day, so the bubble floats against the tear and pushes the retina back into place.
Recovery
- Strict adherence to the positioning instructions in the days following the procedure is essential to success.
- Vision is blurred while the gas bubble is present and clears gradually as it absorbs over one to a few weeks.
- Air travel and altitude changes must be avoided until the gas is fully absorbed.
- Regular follow-up exams are needed to confirm the retina stays attached.
Risks to know about
- The retina can fail to reattach, or new tears can develop, sometimes requiring vitrectomy or scleral buckle surgery afterward.
- Elevated eye pressure can occur, especially in the days after the gas injection.
- Double vision can occur temporarily while the gas bubble is present.
- Because success depends heavily on positioning and tear location, it is not appropriate for every type of detachment.
Frequently asked questions
Is pneumatic retinopexy done in the operating room?
No, it is usually performed in the clinic under local anesthetic drops, without needing an operating room.
What if it doesn't work?
If the retina does not reattach, your surgeon can proceed to vitrectomy or scleral buckle surgery to complete the repair.
How strict does the positioning need to be?
Very strict — your surgeon will give specific instructions on head position and duration, and following them closely is one of the biggest factors in success.
Is this a permanent fix?
When successful, it permanently reattaches the retina at the treated tear, though ongoing monitoring is needed since new tears can occasionally develop elsewhere.
Ready to see us?
Call the appointment desk, or book online — we will confirm your time by phone.
Sources consulted: AAO — What Is Retinal Detachment?, Mayo Clinic — Retinal Detachment (Diagnosis & Treatment) . General medical information — not a substitute for professional diagnosis. Medically reviewed by Dr. Niranjana Bejan Singh.
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