Delayed-Onset Interface Fluid Syndrome After Laser-Assisted In Situ Keratomileusis Secondary to Descemet Stripping Automated Endothelial Keratoplasty

Villarrubia, Alberto; Cano-Ortiz, Antonio

doi:10.1001/jamaophthalmol.2014.960

Cited by 5 publications

(4 citation statements)

References 4 publications

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“…1 Although no clinical signs of interface disruption were documented in the patient's records, and the patient was not treated with steroids in the preoperative period, because AS-OCT was not per-formed, we could not exclude the possible presence of IFS before surgery. Interestingly, as previously observed by Villarrubia et al, 3 the intracorneal fluid accumulated in the LASIK flap interface rather than in the potential space between the donor DSAEK disc and the recipient posterior stroma. These observations may suggest weaker tensile strength of the LASIK flap interface than the DSAEK interface.…”

Section: Discussionsupporting

confidence: 69%

“…Interface fluid syndrome is an unusual complication of LASIK, which usually occurs in the early postoperative period. Only few cases of late occurrences of IFS were reported; after DSAEK, 3 phacotrabeculectomy 4 and acute Posner–Schlossman Syndrome 5 5, 10, and 16 years after LASIK, respectively. To the best of our knowledge, there have been no reports on IFS occurring more than 2 decades after LASIK.…”

Section: Discussionmentioning

confidence: 99%

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Interface Fluid Syndrome 2 Decades After Laser-Assisted In situ Keratomileusis

Assayag

Smadja²,

Roditi³

et al. 2021

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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To report a case of late-onset interface fluid syndrome (IFS) after laser-assisted in situ keratomileusis (LASIK). Methods: A 94-year-old man was referred for evaluation because of persistent corneal edema 10 days after Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) for pseudophakic bullous keratopathy. Results: After an uneventful DSAEK, the patient was treated with topical antibiotics and steroids. On presentation, a well positioned and oriented DSAEK graft was observed in the right eye, yet the cornea was edematous. Applanation tonometry was normal. Anterior-segment optical coherence tomography (AS-OCT) revealed a LASIK flap with a fluid cleft beneath it. Requery confirmed that LASIK was performed 21 years ago. Topical steroids were stopped, and after 2 weeks, the cornea was clear, and AS-OCT revealed complete resolution of the interface fluid. Conclusions: Even decades later, IFS should be considered as a source of corneal edema in patients after LASIK. Monitoring these patients with AS-OCT is recommended.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Interface Fluid Syndrome 2 Decades After Laser-Assisted In situ Keratomileusis

Assayag

Smadja²,

Roditi³

et al. 2021

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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“…In the majority of the reports IFS, i.e. fluid accumulation between the LASIK flap and the stromal bed, is related to high IOP usually due to corticosteroid use in a steroid-responder patient but also because of other causes of acute ocular hypertension [3], [7], [8], [18], [19], [20], [21], [22], [23], [24], [25], [26]. In some cases it has led to advanced and even terminal glaucoma with severe visual loss because the condition was mistakenly confused with diffuse lamellar keratitis (DLK), and IOP was wrongly considered low due to the erroneous readings of the applanation tonometry performed in the central cornea [22], [23], [24], [25].…”

Section: Discussionmentioning

confidence: 99%

Interface Fluid Syndrome (IFS) following Toxic Anterior Segment Syndrome (TASS): not related to high intraocular pressure but to endothelial failure

Galvis

Berrospi

Tello

et al. 2019

Saudi Journal of Ophthalmology

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We describe the case of a 52-year-old female with past history of LASIK, 21 years earlier, without Fuchs’ endothelial dystrophy, who underwent phacoemulsification and intraocular lens (IOL) implantation. During the early postoperative period severe corneal edema, anterior chamber cellularity and iris inflammation presented, accompanied by a clear space along the LASIK interface. Those findings were interpreted as part of a Toxic Anterior Segment Syndrome (TASS) and secondary interface fluid syndrome (IFS). When interface fluid was present, intraocular pressure (IOP) measured in the center of the cornea yielded very low values. In addition, applanation tonometry performed in the corneal periphery, as well as Schiotz tonometry and digital tonometry also indicated that the IOP was not high. Fluid in the interface persisted until a DMEK was carried out 11 months after the phacoemulsification surgery. Five days postoperatively the IFS resolved, confirmed by OCT imaging. The origin of IFS in this case was corneal edema secondary to endothelial cell dysfunction and it was not related to high IOP. This is the first reported case of IFS following TASS, the third case published of DMEK procedure used to solve endothelial failure-related IFS, and the case with the longest time of presentation after LASIK.

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“…tThere have been reported case series of IFS after DMEK and DSAEK; this is a postoperative complication after endothelial keratoplasty in eyes that have had previous LASIK. 16,17,21–25 It is important to note that in our case series, we did not see recurrence of IFS after DMEK. IFS as a postoperative complication after endothelial keratoplasty has been documented to occur due to various factors, such as excessive manipulation of the DMEK donor graft, 22 graft failure, poor donor endothelium and corneal recipient adherence, IOP elevation, fibrous surface irregularities of the donor stroma, 24 and even a diminished oxygen supply induced by the use of a scleral lens.…”

Section: Discussionmentioning

confidence: 51%

Descemet Membrane Endothelial Keratoplasty as Treatment for Late-Onset Interface Fluid Syndrome After Laser In Situ Keratomileusis

Huertas-Bello,

Sem,

Alba

et al. 2024

Cornea

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Purpose: We herein present Descemet membrane endothelial keratoplasty (DMEK) as an effective surgical means of treatment for the management of interface fluid syndrome (IFS) in a series of cases with distant history of laser in situ keratomileusis (LASIK). Methods: Three cases from a single institution were included. All patients had documented IFS in the setting of history of LASIK. All 3 patients underwent DMEK for the treatment of IFS. Visual acuity, clinical findings, pachymetry, endothelial cell count, and anterior segment optical coherence tomography were recorded. Results: We describe 3 cases of late-onset IFS that developed in eyes many years after LASIK (ranging from 15 to 31 years). All 3 patients had clinically significant corneal edema and evidence of poor endothelial function at the time of IFS diagnosis. DMEK was subsequently performed in each case. All 3 eyes showed resolution of corneal edema and improvement in best-corrected visual acuity after DMEK. Conclusions: DMEK can provide successful visual and anatomical recovery in patients who have had previous LASIK and experience late-onset IFS due to endothelial cell dysfunction.

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Delayed-Onset Interface Fluid Syndrome After Laser-Assisted In Situ Keratomileusis Secondary to Descemet Stripping Automated Endothelial Keratoplasty

Cited by 5 publications

References 4 publications

Interface Fluid Syndrome 2 Decades After Laser-Assisted In situ Keratomileusis

Interface Fluid Syndrome 2 Decades After Laser-Assisted In situ Keratomileusis

Interface Fluid Syndrome (IFS) following Toxic Anterior Segment Syndrome (TASS): not related to high intraocular pressure but to endothelial failure

Descemet Membrane Endothelial Keratoplasty as Treatment for Late-Onset Interface Fluid Syndrome After Laser In Situ Keratomileusis

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