After vitrectomy with gas tamponade, the bubble expands with altitude and with nitrous oxide anaesthesia, and the resulting pressure rise can occlude the central retinal artery. Give every patient a wristband or written card stating the gas used and the date, and tell them in plain words: no flying, no mountain travel over high passes, and show this card to any anaesthetist until the gas has gone. Longer-acting gases mean longer restrictions.
- Give a written card or wristband naming the gas and the date of surgery.
- Warn against flying and high-altitude road travel until the bubble has absorbed.
- Tell the patient to show the card before any anaesthetic, to avoid nitrous oxide.
Why it matters
Bubble expansion is a preventable cause of permanent vision loss after a successful repair.
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