Fatal air embolism during endoresection of choroidal melanoma.

Purpose: 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.
Conclusion: 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.