Scleral buckles may improve air travel safety

This prospective study found that although eyes with small volumes of intravitreal gas experienced significant IOP changes during simulated flight, those with scleral buckles were less susceptible to IOP spikes.

These results suggest that such patients can likely tolerate typical air travel without undue risk of dangerous IOP elevation.

Twelve eyes of 12 patients underwent repeated IOP measurement while in a hypobaric chamber that simulated air travel approximately one month after pars plana vitrectomy with 15% C₃F₈ gas fluid exchange.

Patients with scleral buckles had a significantly lower peak IOP than those without buckles (20 mm Hg vs. 32 mm Hg), in addition to a significantly smaller absolute increase in IOP and significantly lower percentage increase in IOP from baseline.

These results demonstrate that even small amounts of gas can cause significant IOP spikes during atmospheric decompression in simulated flight.

They note that there are many factors to consider when determining the suitability of air travel for patients with eyes with intravitreal gas. For example, those with underlying glaucoma or ocular hypertension or who are on antihypertensive drops may have a limited ability to accommodate an expanding gas bubble during depressurization.

When do you allow air travel for patients after pars plana vitrectomy with fluid-gas exchange?