Modeling the Dynamics of Tamponade Multicomponent Gases During Retina Reattachment Surgery

Vitrectomy and pneumatic retinopexy are common surgical procedures used to treat retinal detachment. To reattach the retina, gases are used to inflate the vitreous space allowing the retina to attach by surface tension and buoyancy forces that are superior to the location of the bubble. These procedures require the injection of either a pure tamponade gas, such as C3F8 or SF6, or mixtures of these gases with air. The location of the retinal detachment, the anatomical spread of the retinal defect, and the length of time the defect has persisted, will determine the suggested volume and duration of the gas bubble to allow reattachment. After inflation, the gases are slowly absorbed by the blood allowing the vitreous to be refilled by aqueous. We have developed a model of the mass transfer dynamics of tamponade gases during pneumatic retinopexy or pars plana vitrectomy procedures. The model predicts the expansion and persistence of intraocular gases (C3F8, SF6), oxygen, nitrogen, and carbon dioxide, as well as the intraocular pressure. The model was validated using published literature in rabbits and humans. In addition to correlating the mass transfer dynamics by surface area, permeability, and partial pressure driving forces, the mass transfer dynamics are affected by the percentage of the tamponade gases. Rates were also correlated with the physical properties of the tamponade and blood gases. The model gave accurate predictions in humans. (C) 2017 American Institute of Chemical Engineers