Advertisement

PentaVision

Retinal Physician

Article | 2025 American Society of Retina Specialists Annual Meeting

Video: Getting Gas Tamponade Right

Gaurav Shah, MD, joins Diana Do, MD, to discuss how errors in intraocular gas concentration can lead to preventable blindness, and what surgeons can do to avoid vision-threatening mistakes.

By: Gaurav K. Shah, MD, Diana V. Do, MD
Retinal Physician August 2, 2025 Vol 22, Issue July/August 2025
At ASRS 2025, Gaurav K. Shah, MD, presented on the use of incorrect intraocular gas tamponades during vitreoretinal surgery.

The following transcript has been edited for clarity:

 

Hi, I am Diana Do, MD, with Retinal Physician. I have the pleasure of discussing intraocular tamponades with Gaurav Shah, MD, from West Coast Retina. I know you presented this exciting paper about using the correct tamponade agent. Give us the highlights of your paper presentation.

Gaurav Shah, MD: Sure. The highlight is that we use a lot of tamponades, and one of the things we use are gases. Gases can do a lot of good things, but if improperly mixed, they can do a lot of bad things. I’m going to present a series of cases. In my role with OMIC, we see these cases of wrong gas tamponade, and these are eyes that have either gone to NLP or phthisis. All of us retina specialists took eyes that were seeing, and now the best vision is no light perception. I just don't think it can happen in this day and age, and we have to be cognizant, recognize it, and more importantly, prevent this from happening because it is a medicolegal issue, but it’s more a patient care issue. I almost think that wrong-site surgery is number one, and this is number two and can't happen. So it really comes to distractions not having a timeout procedure. I'm going to outline those tomorrow, but really paying attention at the end of the case. And also maybe think of mixing the gases up yourself or really watching somebody do this.

These are preventable errors. We know PVR many times can’t be prevented, but this is something preventable, and I think it’s really important that we take a step back and do the right thing, because it’s patient's lives and vision at risk.

Diana Do, MD: Yes. In my patients, if I have use of intraocular tamponades, I always like to mix the gas myself to make sure I have the correct concentration. How about you?

Gaurav Shah, MD: Absolutely. It’s 10 seconds, 20 seconds, or 5 minutes. But you want to make sure that you do this correctly, because if you don’t, then yes, you have the lawsuit issue. But, again, I want to emphasize it's about patient safety and outcomes. We're an outcomes-driven business and for all of our patients, we have to make sure that as good of a timeout we do at the beginning of surgery we need at the end of surgery.

Diana Do, MD: Thank you so much for bringing up this very important topic and for all your leadership in surgical education. RP