Dr. SIMAR RAJAN SINGH

DR. DEEKSHA KATOCH, DR. MOHIT DOGRA, DR. RAMANDEEP SINGH

Abstract

Ocular venous air embolism (OVAE) is a potentially fatal complication which has been rarely reported during vitrectomy. A 1-year-old child underwent lensectomy and vitrectomy for stage 5 retinopathy of prematurity (ROP). An anterior chamber maintainer was used for infusion while two 27-gauge valved ports with iris-root entry were used for lensectomy and bimanual dissection. At the end of the surgery fluid-air exchange (FAX) was initiated at 30mmHg and the scleral ports were removed. At this point end-tidal carbon dioxide of the patient dropped from 35mmHg to 16mmHg and oxygen saturation fell from 100% to 68% within one minute. A diagnosis of OVAE was considered and FAX was promptly stopped. Nitrous oxide was stopped, 100% oxygen was administered, and intravenous fluid bolus was given. The patient gradually recovered and was extubated uneventfully. We report the first case of OVAE in stage 5 ROP surgery and discuss the potential hypothesis and preventive measures for the same.