Abstract

The video describes the strategies for treating pre-existing CDs along with RRDs and managing sudden intra-operative CDs. Cannula-guided choroidal drainage is necessary to decrease the severity of pre-existing CDs. Rarely accidental air entry inside the suprachoroidal space due to inadvertent slippage of a non-sutured infusion cannula tip can precipitate sudden kissing CD. If the air infusion pressure is 40 mm Hg or more, this suprachoroidal air can cause a tear in the vortex vein ampullae, and air enters inside the vortex vein. Possible life-threatening Venous Air Embolism (VAE), known as “PRESUMED AIR BY VITRECTOMY EMBOLISATION (PAVE)” may happen due to pulmonary embolism or occlusion of systemic arteries. Immediate stoppage of the air infusion and removing it can prevent this accidental PAVE and eventual death. In this era of MIVS, this risk is likely to be higher than in previous decades, when infusion cannulas were used to be sutured to the sclera.