Interface Fluid After LASIK: Misleading Tonometry Can Lead to End-Stage Glaucoma

Najman-Vainer, Jacobo; Smith, R. Scott; Maloney, Robert K.

doi:10.1016/s0886-3350(00)00382-5

Cited by 52 publications

(25 citation statements)

References 1 publication

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“…In 2000, Najman-Vainer et al 3 reported the case of a patient with IFS, referred to them 6 months after surgery, who finally reached a visual acuity of light perception alone and the optic nerve cup-to-disc ratio was 1.0.…”

Section: Discussionmentioning

confidence: 99%

Post-LASIK edema-induced keratopathy (PLEK), a new name based on pathophysiology of the condition

et al. 2012

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A 33-year-old man who underwent uneventful laser in situ keratomileusis (LASIK) developed pressure-induced stromal edema resulting in an interface haze in both eyes and a pocket of fluid under the flap of the right eye 10 days after surgery, while receiving topical fluorometholone. Intraocular pressure by applanation tonometry was 16 mm Hg in his right eye (erroneous result due to the fluid in the interface) and 34 mm Hg in his left eye. After discontinuation of steroids and addition of ocular hypotensive medication, interface fluid collection disappeared in his right eye. Visual acuity improved and haze diminished in both eyes. This case illustrates that in the same patient a post-LASIK edema induced syndrome may be present with or without fluid in the interface, suggesting that both clinical pictures could be manifestations of a broad spectrum of the same condition. We suggest a new name for this non-inflammatory disorder: post-LASIK edema-induced keratopathy (PLEK).

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Section: Discussionmentioning

confidence: 99%

Post-LASIK edema-induced keratopathy (PLEK), a new name based on pathophysiology of the condition

et al. 2012

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“…It would be more accurate to measure IOP with other types of tonometry, especially dynamic contour tonometry, which may be less affected by CCT. Clinically, inaccurately low measurements of central IOP owing to cushioning of the fluid pocket can also confuse the diagnosis [15]. …”

Section: Discussionmentioning

confidence: 99%

Corneal densitometry changes in a patient with interface fluid syndrome after small incision lenticule extraction

Zheng

Han

et al. 2017

BMC Ophthalmol

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BackgroundTo report a case of interface fluid syndrome (IFS) following small incision lenticule extraction (SMILE) evaluated with corneal densitometry and optical coherence tomography (OCT).Case presentationAn 18-year-old man reported sudden vision loss 24 days after SMILE procedure. Intraocular pressure (IOP) was 36.3 mmHg (OD) and 36.7 mmHg (OS) by noncontact tonometry. Moderate corneal edema, interface fluid pocket and haze were observed by OCT and confirmed by corneal densitometry values. Discontinuation of steroids and addition of hypotensive medication were offered immediately. The symptoms were cured after the medication. Changes of corneal densitometry were consistent with the clinical course of IFS.ConclusionThis case illustrates that it is crucial to be aware that a history of SMILE can also cause IFS. Both OCT and corneal densitometry can serve as auxiliary means to evaluate the clinical course of IFS, and appropriate IOP management is an effective approach.

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“…Falsely measured low IOP, from readings taken overlying the interface fluid, may cause a delay in diagnosis and treatment, resulting in significant visual loss. 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.…”

Section: Discussionmentioning

confidence: 99%

Persistent interface fluid syndrome

Hoffman¹,

Fine²,

Packer³

2008

Journal of Cataract and Refractive Surgery

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We present an unusual case of persistent interface fluid that would not resolve despite normal intraocular pressure and corneal endothelial replacement with Descemet-stripping endothelial keratoplasty. Dissection, elevation, and repositioning of the laser in situ keratomileusis flap were required to resolve the interface fluid. Circumferential corneal graft-host margin scar formation acting as a mechanical strut may have been the cause of the intractable interface fluid.

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Interface Fluid After LASIK: Misleading Tonometry Can Lead to End-Stage Glaucoma

Cited by 52 publications

References 1 publication

Post-LASIK edema-induced keratopathy (PLEK), a new name based on pathophysiology of the condition

Post-LASIK edema-induced keratopathy (PLEK), a new name based on pathophysiology of the condition

Corneal densitometry changes in a patient with interface fluid syndrome after small incision lenticule extraction

Persistent interface fluid syndrome

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