Abstract

SA.11.05

Ophthalmic risks after eye surgery during air travel caused by loss of pressure in cabin

Brandl H.
Flugmedizinisches Institut der Luftwaffe, Fürstenfeldbruck

Objective: Air transports of injured and wounded people are conducted as daily business nowadays. Airplanes of medical service / flying ambulance organisations cover great distances with inner pressure values of ca 1500 m until ca 2750 m height above sea level in cabin compartment whereas these airplanes are cruising in 10.000 m height above sea level in reality. In cabin compartments without air pressure stabilising equipments, there will be ambient pressure (Umgebungsdruck) which is equal to the real cruising altitude of the aircraft. For example: real cruising altitude for rescue helicopter in mountains or during out of area operations of German Air Force will be until 4500 m height above sea level.
For surgical management of complex retinal detachments including vitrectomy a gas tamponade is indicated in certain cases. For those intraocular gas tamponades the physical properties of the used gases at normal pressure and defined temperature and absorption features are well known. For post-op follow up it has to taken into consideration that the intraocular gases can cause serious adverse events (side effects) if the ambient pressure conditions are changed.
Methods: In vitro tests, especially physical models were used to determine the volumes of gas tamponades in human eyes which are acceptable during post-op carriage of patients by air and which were also adjusted to the individual patient.
Results: Based on safety factors (considering also unexpected circumstances during the flight, e.g loss of airpressure in the cabin or extraordinary climb flight values) data of maximal intraocular volumes used for gas tamponades are presented, which are acceptable in the eye at the time of take off without causing eye damages.
Conclusions: Important information regarding carriage of patients by air after eye surgery including gas tamponade are presented. This is crucial in order to avoid serious unexpected adverse reactions. Additionally a discussion will be offered concerning air pressure changes which may cause cornea stress conditions. These details may be relevant especially after refractive surgery

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