Retinal reattachment by continuous vitreous insufflation

Intraocular gas bubbles can occlude retinal breaks and lead to retinal reattachment, but inferior breaks can be difficult to occlude. We hypothesized that an automated air injector connected to the eye would progressively fill the vitreous cavity with a bubble and occlude all, even inferior, breaks. This technique, termed continuous vitreous insufflation, was applied in 30 eyes of 15 rabbits using an air pressure of 50 mm Hg. Thirteen study eyes underwent lensectomy, vitrectomy, and rhegmatogenous retinal detachment; 17 eyes did not. In each eye with a patent cannula, a bubble virtually filled the vitreous cavity within about 24 hours, and all detached retinas became reattached except those with large breaks. Because large bubbles should be effective in closing most breaks, continuous vitreous insufflation may enable high reattachment rates. Accordingly, this procedure may prove valuable in treating certain retinal detachments in humans, although there are obstacles to clinical application.