Effect of nitrous oxide on gas bubble volume in the anterior chamber

Nitrous oxide is often used as anesthesia during ophthalmic surgery that requires intraocular injection of sulfur hexafluoride gas or air. Ventilation with N2O is known to increase intraocular pressure in the presence of intraocular bubbles, but little is known about the effect of N2O on intraocular bubble volume. Accordingly, we have compared the effect of N2O:O2 ventilation (66% N2O, balance O2) with that of air ventilation and oxygen ventilation on intraocular bubbles of SF6 or air. Aspiration of anterior chamber gas after 180 minutes of N2O:O2 ventilation in cats showed an increase in bubble volume of more than threefold when the original intraocular bubble was SF6 and an increase of more than twofold when the original intraocular bubble was air. In contrast, during air ventilation, intraocular SF6 bubble volume increased by 50%, and intraocular air bubble volume increased by only 7.5%. During O2 ventilation, intraocular SF6 bubble volume increased by 35%, and intraocular air bubble volume decreased by 13%. Our results indicate that N2O is contraindicated when gas is injected into the closed eye.