Fatal air embolism during endoresection of choroidal melanoma.
OBJECTIVE
To describe a case of intraoperative mortality because of air embolism during resection of a choroidal melanoma by pars plana vitrectomy.


METHODS
Retrospective interventional case report.


RESULTS
A 69-year-old man died unexpectedly at the time of pars plana vitrectomy. The operative technique involved the use of high-pressure air (60 mmHg) in the presence of traumatically exposed choroidal vasculature. Autopsy revealed a large air embolus in the right ventricle, which resulted in sudden cardiovascular collapse.


CONCLUSIONS
Air embolism is a rare complication of ophthalmic surgery. Infusion of air in the presence of traumatically exposed choroidal vasculature exposes the patient to the risk of air embolism. Ophthalmic surgeons and anesthetists should be aware of the possibility of air embolism during certain ophthalmic procedures, and appropriate intraoperative monitoring should be considered.
Departments of *Ophthalmology, and †Forensic Pathology, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
James C
JC
Rice
Linda
L
Liebenberg
Raoul P
RP
Scholtz
Gregory
G
Torr
D000368:Aged; D002830:Choroid Neoplasms / Q000601:surgery*; D004618:Embolism, Air / Q000209:etiology*; D017809:Fatal Outcome; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D008297:Male; D008545:Melanoma / Q000601:surgery*; D012189:Retrospective Studies; D014821:Vitrectomy / Q000009:adverse effects*