We report a case of possible air embolism during a three-port pars plana vitrectomy and air-fluid exchange of the vitreous cavity of the eye. After the start of intraocular air flushing, sudden tachycardia, a decrease in oxygen saturation and end-tidal carbon dioxide tension, and a distinct “mill-wheel” murmur were observed. Venous air embolism was suspected but other sources of air entry into the circulation and a thromboembolic event were excluded. Once intraocular air flushing was ceased, clinical variables returned to normal within minutes. In conclusion, during air-fluid exchange of the vitreous cavity, air embolism should be considered as a possible rare complication.
IMPLICATIONS: Although complications of eye surgery are infrequent and normally not severe, this report deals with the potentially life-threatening hazard of air embolism. Because the potential for harm and successful therapy are time-dependent, the possibility of air embolism should be considered, despite its apparent rarity.
*Department of Anaesthesiology and Intensive Care Medicine, University Hospital Kiel; and †Eye Hospital Bellevue, Kiel, Germany
Accepted for publication December 9, 2004.
Address correspondence and reprint requests to Thomas Ledowski, MD, Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Schwanenweg 21, D24105 Kiel, Germany. Address e-mail to email@example.com.