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

Abstract

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.

Interface Fluid Syndrome Masquerading as Diffuse Lamellar Keratitis After Small Incision Lenticule Extraction

“…Similar to SMILE, steroid-induced IOP elevation is the most common cause of early and late-onset IFS in LASIK [17][18][19]. Other less common causes of IOP elevation that can lead to IFS include failed glaucoma surgery, gas tamponade or silicone oil after vitreoretinal surgery, traumatic hyphema, retained viscoelastic after cataract surgery, and uveitis [20][21][22][23].…”

Role of AS-OCT in Managing Corneal Disorders

“…Another post-operative application of AS-OCT, in corneal flap-based procedures is the detection of interface fluid syndrome (IFS) which usually presents in the early post operative period but has been documented even after two years post-surgery [70]. IFS post LASIK is a rare but potentially sight threatening complication because of increase in the intraocular pressure.…”