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Evaluating the safety of air travel for patients with scleral buckles and small volumes of intraocular gas
  1. Jason Noble1,2,
  2. Navapol Kanchanaranya1,
  3. Robert G Devenyi1,3,
  4. Wai-Ching Lam1,3
  1. 1Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
  2. 2Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
  3. 3Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
  1. Correspondence to Dr Wai-Ching Lam, Toronto Western Hospital, East Wing 6-432, 399 Bathurst Street, Toronto, Ontario, Canada M5T 2S8; waiching.lam{at}


Aim To evaluate the effect of scleral buckling on intraocular pressure (IOP) change during atmospheric decompression for eyes with small volumes of intravitreal gas.

Methods 12 eyes of 12 patients, including 6 with and 6 without scleral buckles, were evaluated in a hypobaric chamber simulating air travel approximately 1 month post pars plana vitrectomy with 15% C3F8 gas fluid exchange. The chamber was decompressed with an ascent rate of 300 feet/min to a peak altitude of 8000 feet. After 15 min of cruising, descent was undertaken at 300 feet/min. IOP was measured at baseline and then every 5 min using slit-lamp mounted Goldmann applanation tonometry. The data were entered onto a spreadsheet and comparative statistics were done.

Results During ascent, IOP steadily rose from an average of 13±3 mm Hg to a peak of 26±9 mm Hg at 8000 feet. Patients with scleral buckles had significantly lower peak IOPs compared with those without buckles (20±5 mm Hg vs 32±8 mm Hg, p=0.013, t test) representing lower absolute increases in IOP (7±1 mm Hg vs 19±7 mm Hg, p=0.001, t test) and lower percentage increases in IOP from baseline (62±25% vs 140±40%, respectively).

Conclusions Eyes with small volumes of intravitreal gas demonstrate significant IOP changes during atmospheric decompression in simulated flight. The presence of a scleral buckle significantly limits the magnitude of IOP change, suggesting that such patients can likely tolerate typical air travel without undue risk of dangerous IOP elevation.

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