Interface fluid syndrome in laser in situ keratomileusis after complicated trabeculectomy

Abstract

A 69-year-old man developed stromal edema and a pocket of fluid in the laser in situ keratomileusis (LASIK) interface wound in the left eye after acute endothelial cell loss from complicated trabeculectomy. He eventually required penetrating keratoplasty along with cataract surgery. Histologic examination of the corneal button showed an edematous 720 microm central residual stromal bed, a 54 microm empty space at the level of the central interface wound, and a 154 microm LASIK flap. The endothelial cell count was 0 to 2 cells per high-power field, corresponding to a cell density of 450 to 500 cells/mm(2). Four years after LASIK, the central interface wound was susceptible to forming a pocket of serous fluid after the corneal endothelial function was compromised.

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

“…Use of steroids is the most common reason of IFS [3, 4]. Other causes of IFS after LASIK are related to transient or permanent corneal endothelial cell decompensation in eyes with anterior uveitis [10], Fuchs endothelial dystrophy [8], traumatic hyphema [14] and eyes that have undergone certain procedures such as cataract surgery [7], vitreoretinal surgery [6], Descemet stripping automated endothelial keratoplasty (DSAEK) [5] or trabeculectomy [9]. These risk factors for interface fluid syndrome after LASIK should also be noted in post-SMILE eyes.…”

Presumed late diffuse lamellar keratitis progressing to interface fluid syndrome

“…Interface fluid syndrome has been reported in association with increased intraocular pressure (IOP) following topical corticosteroid treatment 3,4 and uveitis 5 and in cases with reduced corneal endothelial cell function. 6,7 We report an unusual case of presumed late-onset unilateral DLK 8 that progressed to IFS after treatment with topical corticosteroid therapy. …”

Delayed-onset interface fluid syndrome after laser in situ keratomileusis secondary to combined cataract and vitreoretinal surgery

“…The syndrome is reported to be caused by increased intraocular pressure (IOP), 1,2 uveitis, and corneal endothelial cell decompensation. [3][4][5] Typical cases of interface fluid syndrome are associated with steroid-induced IOP increase 2 weeks to 6 months after LASIK. 4 A comprehensive search of the Medline database did not show interface fluid syndrome following intraocular surgery or cases that developed more than 10 years after LASIK.…”