Terms: ocular venous air embolism, presumed air by vitrectomy embolisation
Clinical features:
(1) The patient is undergoing vitrectomy with air infusion.
(2) There is a slippage of the infusion cannula.
(3) There is a choroidal detachment or wound.
(4) There is a precipitous drop in end-tidal CO2.
(5) There is evidence of cardiovascular collapse.
Suprachoroidal infusion of pressurized air can tear vortex veins with introduction of air into the systemic venous circulation, potentially causing an air embolism.
This can be avoided by:
(1) having a "time out" before air infusion to confirm infusion cannula positioning in the intravitreal space
(2) immediately stop the air infusion if choroidal detachment is detected