Grossly False Applanation Tonometry Associated with Interface Fluid in Susceptible LASIK Patients

Corneal Toxicity From Topical Ocular and Systemic Medications

“…However, most physicians are vigilant in monitoring for the most common adverse drug reactions, posterior subcapsular cataracts and glaucoma, associated with this class of medication. 64 Pressure measurements obtained from the center of the cornea can be read as low or normal even when the IOP is dangerously high. Steroid preparations may retard corneal wound healing and prevent reepithelialization of the cornea.…”

Evaluation of Tonometric Correction Factors

“…IOP is reported to be underestimated post surgery. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Ehlers and coworkers 21 developed a nomogram based on manometric experiments (we shall refer to this as the Ehlers model) for correction of IOP for the errors induced due to normal CCT variation. Orssengo and Pye 22 later proposed a theoretical model (which we shall refer to as the O&P model) for determining what they termed the ''True IOP''; this corrects the IOP for the errors induced due to CCT as well as corneal curvature.…”

Persistent interface fluid syndrome

“…3,13 In addition, this clinical setting may be exacerbated by an inaccurate diagnosis of diffuse lamellar keratitis and an increase in the dose of topical steroids. 5,6 Measuring the IOP in the corneal periphery, outside the area of interface fluid, will reveal a more accurate assessment of the true elevated IOP and aid in the diagnosis. When IFS develops despite relatively normal peripheral IOP measurements, the corneal endothelium becomes the suspect for the mechanism of interface fluid accumulation.…”

“…[7][8][9][10][11] The IFS usually resolves with normalization of the IOP or return of normal endothelial cell function through pharmacological or surgical means. 1,2,[4][5][6]8,9 We present a case of persistent interface fluid in a patient who had had penetrating keratoplasty (PKP) followed by LASIK and LASIK enhancement procedures. The interface fluid persisted despite a normal IOP and a subsequent endothelial keratoplasty.…”

“…Accumulation of fluid within a laser in situ keratomileusis (LASIK) interface has most often been attributed to increased intraocular pressure (IOP) from steroid-induced glaucoma, [1][2][3][4][5][6] but it has also been described in eyes with damaged or compromised endothelial cell function. [7][8][9][10][11] The IFS usually resolves with normalization of the IOP or return of normal endothelial cell function through pharmacological or surgical means.…”