Intra-vitreal gas injection and supine positioning for hypotony post-intrascleral intraocular lens fixation

PURPOSE: This study aimed to report a case of intravitreal gas injection in the supine position for hypotony after intrascleral intraocular lens (IOL) fixation in a patient with Vogt-Koyanagi-Harada (VKH) disease. OBSERVATIONS: A 72-year-old Japanese female patient presented with blurred vision in her right eye. Both eyes exhibited a sunset glow fundus due to VKH disease. The right IOL was dislocated; therefore, IOL fixation was performed. The patient's hypotony and choroidal effusion persisted postoperatively and her intraocular pressure (IOP) remained 2–4 mmHg despite the performance of two steroid courses. C3F8 (perfluoro pane gas) was injected into the vitreous cavity on postoperative day 35. The patient was instructed to assume a supine position on the third day after injection. At 6 days post-injection, her IOP began to rise; her IOP remained within the normal range until 1 year later. CONCLUSIONS AND IMPORTANCE: This is the first report of successful intravitreal gas injection in a supinated patient with VKH disease to treat postoperative hypotony.