![]() Tamponade means the force of the gas pressing against the retina to facilitate its re-positioning into its natural position when the retina is detached. In these cases the function of the gas is not to ‘’make space,’’ or to help visualise endo-ocular structures (which, on the contrary, makes them more difficult to identify), but that of tamponade. These gases are used in vitreo-retinal surgery, in particular in surgery for retinal detachment or macular disease. Long lasting gas inside the eye can cause serious problems for those patients who are too quick in wanting to get back to scuba diving. In operating the posterior segment of the eye However, it must be noted that, even if there is no more gas in the eye, it is recommended to wait at least 2 months after the operation before diving again, to avoid infections or knocking the operation wound. Given that the quantity of air used in the anterior chamber is very small, the gas is reabsorbed within one or two days and therefore does not cause problems for patients who then decide to scuba dive after the operation wound has healed. The function of gas in these cases is to create space and a means of separating the endo-ocular structures which the surgeon has to operate on. The use of gas in this type of surgery is quite rare nowadays, as some substances with visco-elastic properties have, at least in more modern surgical practice, replaced the use of air. In operating the anterior segment of the eye, in particular he cataract and glaucoma, the gas used is actually only air. Subsequently, long lasting pure gases and mixtures of gas were used, and they are still in use now, in operations for vitreo-retinal conditions, in particular in pneumatic retinopexy and vitrectomy operations. In the second half of the last century, eye surgeons started using air to assist in scleral buckling surgical procedures for retinal detachment. The first attempt to use intravitreal gas in treating retinal detachment dates back to 1909. However, the use of gas in eye surgery dates back to the beginning of the last century. In reality this can be considered the first example of laboratory engineered decompression sickness in the history of medicine. However, he was unable to explain exactly how it was formed. A viper was subject to decompression with his machine, and the presence of a gas bubble in its eye was observed. Robert Boyle built a hyperbaric chamber and put different animals into it. The first observations of a gas bubble in an animal’s eye date back to 1607. To make this easier to understand for all readers, we will avoid using mathematical formulae and we will explain physics concepts, the meanings of which can sometimes be difficult to grasp. In this article, we will look at the use of gas in eye operations, in particular in vitreo-retinal surgical procedures, and how this use can cause patients to reduce the amount of scuba diving they do following the operation. In these cases, the presence of gas in the post-operation period can constitute a contraindication in scuba diving. For example, in certain phases of abdominal surgery, gynaecology and opthalmology. For therapeutic purposes, gases are sometimes used during surgical procedures. For diagnostic purposes, they are sometimes used in radiology. Gases are also used by doctors for diagnostic and therapeutic purposes. Excluding some unusual pathological conditions, the most common cause of this unusual presence of gas is iatrogenic, that is to say, induced by medical procedures. However, there are some unusual circumstances in which a gas is present in parts of the body where it should not normally be. The latter is the cause of so-called "decompression sickness." In normal conditions, where do we usually find gases in our body? As all scuba divers know, gases are found in the lungs, in the airways, in the middle part of the ear, in the paranasal sinuses, in the intestine etc. With the decrease of tissue pressure however, the gases increase in volume and tend to pass from a liquid state to a decompression, forming bubbles. ![]() With an increase in tissue pressure, the gases drop in volume and tend to dissolve into organic liquids. In fact, while the liquids in our body are practically impossible to compress, gases respond to variations in tissue pressure with variations in the volume occupied by the gas itself. One of the most difficult challenges in scuba diving is the prevention of accidents linked to the presence of gas in the human body.
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