Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Feb 12:26:101385.
doi: 10.1016/j.ajoc.2022.101385. eCollection 2022 Jun.

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

Miho Kumoi  1 , Satoshi Matsuda  1 , Takanori Matsuoka  1 , Chieko Tsujino  1 , Yasumasa Otori  1
Affiliations
Case Reports

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

Miho Kumoi et al. Am J Ophthalmol Case Rep. .

Abstract

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.

Keywords: Gas injection; Hypotony; Supine position; VKH.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
a) The IOL and anterior capsule of the right eye hanging over the pupil. b) A sunset glow fundus was observed within the right eye. IOL, intraocular lens.
Fig. 2
Fig. 2
On postoperative day 1, hypotony maculopathy and choroidal effusion were noted in the right eye. Despite two courses of steroid pulse therapy, the patient's IOP remained low (i.e., 2–4 mmHg). Choroidal effusion and hypotony maculopathy persisted for >3 weeks postoperatively. C3F8 was injected into the vitreous cavity on postoperative day 35, and 3 days later the patient was placed in a supine position. The patient's visual acuity improved hours after the injection. At 6 days after the injection, the patient's IOP increased to 6 mmHg, and the choroidal effusion and hypotony maculopathy disappeared. IOP, intraocular pressure.
See this image and copyright information in PMC

References

    1. Pederson J.E. Ocular hypotony. Trans Ophthalmol Soc U K. 1986;105(2):220–226. - PubMed
    1. Sen A.H.N., Drye L.T., Goldstein D.A., et al. Hypotony in patients with uveitis: the multicenter uveitis steroid treatment (MUST) trial. Ocul Immunol Inflamm. 2012;20(2):104–112. - PMC - PubMed
    1. Fannin L.A., Schiffman J.C., Budenz D.L. Risk factors for hypotony maculopathy. Ophthalmology. 2003;110(6):1185–1191. - PubMed
    1. Toris C.B., Pederson J.E. Aqueous humor dynamics in experimental iridocyclitis. Invest Ophthalmol Vis Sci. 1987;28(3):477–481. - PubMed
    1. Daniele S., Schepens C.L. Can chronic bulbar hypotony be responsible for uveal effusion? Report of two cases. Ophthalmic Surg. 1989;20(12):872–875. - PubMed

Publication types

LinkOut - more resources