Interface Fluid Syndrome Research Articles

Active storage machine can unveil previous LASIK surgery by reproducing ex vivo interface fluid syndrome during eye banking

Active storage machine can unveil previous LASIK surgery by reproducing ex vivo interface fluid syndrome during eye banking

Letter Regarding: Corneal Edema as the Sine Qua Non Factor in the Pathophysiology of Interface Fluid Syndrome.

Letter Regarding: Corneal Edema as the Sine Qua Non Factor in the Pathophysiology of Interface Fluid Syndrome.

Delayed interface fluid syndrome in a post laser-assisted in situ keratomileusis: A rare complication

Interface fluid syndrome (IFS) is a rare complication seen post-laser-assisted in situ keratomileusis (post-LASIK). This report describes two unusual cases in which patients underwent ocular surgeries and developed delayed onset interface fluid. Both the patients had undergone uneventful laser-assisted in situ keratomileusis (LASIK) decades ago; case 1 underwent uneventful phacoemulsification and vitrectomy with gas tamponade and case 2 underwent uneventful phacoemulsification with intraocular lens implantation. Possible causes of IFS could be steroid-induced intraocular pressure (IOP) spike, intraocular inflammation, or both. IFS can be seen any time after refractive surgeries and can be a lifelong complication after LASIK surgery. Inaccurate IOP measurement due to underestimation should be borne in mind while measuring IOP in such patients. This report highlights the challenges in diagnosing IFS and the importance of correct IOP measurement in such cases to avoid irreversible vision loss.

An Enigmatic Fluid Accumulation Following Descemet Membrane Endothelial Keratoplasty After Prior Laser In Situ Keratomileusis

Purpose: To report a case of interface fluid syndrome (IFS) following Descemet membrane endothelial keratoplasty (DMEK) 13 years after laser in situ keratomileusis (LASIK). Methods: A 79-year-old patient with bullous keratopathy underwent uneventful DMEK. Thirteen years prior, he had undergone LASIK. After DMEK, he developed an IFS, which was confirmed by a fluid accumulation in the flap interface, visible in the anterior segment optical coherence tomography (AS-OCT). In this case, IFS is presumed to have been triggered by the corticosteroid eye drops administered postoperatively. Measurements of the intraocular pressure (IOP) via applanation tonometry yielded erroneously low results. Results: The discontinuation of the corticosteroid eye drops, along with the initiation of IOP-lowering therapy, led to an improvement in fluid accumulation and a decrease in IOP. Regular ophthalmic examinations with a palpatory assessment of IOP and monitoring of fluid via AS-OCT are recommended. In this case, no more fluid could be detected in the flap interface after 14 months, and IOP was normal. Conclusions: IFS can occur many years after LASIK treatment. Corticosteroids should be discontinued, and IOP-lowering therapy should be initiated to prevent irreversible damage to the optic nerve. Applanation tonometry leads to inaccurately low IOP measurements; therefore, a palpatory assessment of IOP is recommended. AS-OCT is a crucial imaging modality that should be employed for monitoring.

Erratum to: Interface fluid syndrome after LASIK surgery: retrospective pooled analysis and systematic review.

Erratum to: Interface fluid syndrome after LASIK surgery: retrospective pooled analysis and systematic review.

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

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). 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. 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. 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.

Interface fluid syndrome caused by the corneal perforation injury after small incision lenticule extraction: a case report

BackgroundTo report a case of interface fluid syndrome (IFS) following traumatic corneal perforation repair after small incision lenticule extraction (SMILE).Case presentationA 23-year-old woman, with a past history of SMILE, was struck in the left eye with a barbecue prod and subsequently underwent corneal perforation repair at local hospital. Primary wound repaired with a single 10 − 0 nylon suture at the area of leakage. After the surgery, her best corrected visual acuity (BCVA) was 20/30. Four days later, she presented at our hospital with blurred vision, and interface fluid syndrome (IFS) was diagnosed. Intraoperative optical coherence tomography (iOCT) was used to guide the resuturing of the corneal perforation in the left eye, followed by anterior chamber gas injection. At the first postoperative month, the BCVA was 20/25. The corneal cap adhered closely to the stroma, the surface became smooth.ConclusionsThis case illustrates that any corneal perforation following lamellar surgery, including SMILE, may lead to IFS. It is crucial to consider the depth of corneal perforation, and intraoperative optical coherence tomography (iOCT) plays a unique role in the repair procedure.

Treatment of Interface Fluid Syndrome after Laser-Assisted In Situ Keratomileusis with Descemet Membrane Endothelial Keratoplasty in Three Patients with Corneal Endothelial Dysfunction

Treatment of Interface Fluid Syndrome after Laser-Assisted In Situ Keratomileusis with Descemet Membrane Endothelial Keratoplasty in Three Patients with Corneal Endothelial Dysfunction

Interface Fluid Syndrome After Descemet Membrane Endothelial Keratoplasty in Patients With History of LASIK.

The aim of this study was to evaluate the visual, pachymetric, tomographic, and biomicroscopic findings in a series of cases with laser in situ keratomileusis (LASIK) flap interface fluid syndrome (IFS) after Descemet membrane endothelial keratoplasty (DMEK). Six cases were included in this study; all patients had a history of LASIK and underwent DMEK for the treatment of bullous keratopathy. After uneventful surgery, all patients presented with corneal edema and IFS under the LASIK flap, which was demonstrated with anterior segment optical coherence tomography (AS-OCT). Visual acuity, clinical findings, pachymetry, endothelial cell count, and AS-OCT were documented during the management of these cases. IFS appears 2.33 days (±1.03) after DMEK. One case improved with conservative treatment. In 5 cases, the LASIK flap was lifted, the fluid was drained, and the flap was replaced. The mean best-corrected visual acuity after fluid drainage was 0.44 logMAR (range 0.18-1.0) and mean central corneal thickness was 538 μm ± 160. Total resolution of the IFS was achieved at 14.5 days (range 4-30) after DMEK. AS-OCT showed resolution of the flap interface in 5 of 6 cases, while 1 patient required second DMEK due to reaccumulation of the interface fluid. IFS can occur after DMEK in patients with previous LASIK. AS-OCT is a valuable tool for monitoring these cases preoperatively and postoperatively. Early surgical management is often needed to achieve resolution.

Interface Fluid Syndrome After Bioptics Surgery

PURPOSE: To present a case of interface fluid syndrome (IFS) in a patient who underwent laser in situ keratomileusis (LASIK) followed by Implantable Collamer Lens (ICL) implantation. METHODS: Case report. RESULTS: A patient who had undergone astigmatic LASIK followed by ICL implantation elsewhere and was taking a postoperative regimen of topical steroid and lubricants was referred at 4 months postoperatively with uncorrected distance visual acuity (UDVA) of 20/400 in the left eye. The pupil was sluggish, there was severe corneal edema, and intraocular pressure (IOP) was 5 mm Hg with Goldmann applanation tonometry. Anterior segment optical coherence tomography indicated IFS. IFS was diagnosed and steroid-induced ocular hypertension was suspected. IFS likely resulted in the low central IOP readings but the peripheral IOP was 41 mm Hg. Topical steroids were halted and topical tafluprost every night and acetazolamide 250 mg four times a day were prescribed. By day 6 after presentation, the cornea was clear with complete resolution of IFS, UDVA was 20/25, and central and peripheral IOP was 14 mm Hg. CONCLUSIONS: IFS should be considered in patients who have had bioptics surgery and present with low to normal IOP, corneal edema, and decreased vision. [ Journal of Refractive Surgery Case Reports. 2022;2(1):e10–e13.]

Late-onset Descemet's membrane detachment secondary to presumed interface fluid syndrome after uneventful deep anterior lamellar keratoplasty for keratoconus

A forty-year-old male underwent an uneventful big-bubble deep anterior lamellar keratoplasty (DALK) for keratoconus in the right eye. Suture removal was attempted 15 months post-surgery and led to temporal graft host dehiscence that required resuturing of the graft. The patient presented 4 months later with increased intraocular pressure (IOP), graft edema, and nasal Descemet membrane detachment (DMD). IOP control with medication led to reduction and total resolution of DMD and a clear graft. We postulate that the DMD, in this case, was caused by a mechanism similar to the interface fluid syndrome (IFS) that occurs in post-laser in situ keratomileusis (LASIK) eyes and should be considered as a differential diagnosis for DMD following DALK.

Interface Fluid Syndrome After Descemet Membrane Endothelial Keratoplasty

PURPOSE: To describe a case of interface fluid syndrome in a patient with a remote history of laser in situ keratomileusis (LASIK) and recent staged cataract surgery and Descemet membrane endothelial keratoplasty (DMEK). METHODS: A 65-year-old man presented with visual impairment in the left eye in the setting of Fuchs' endothelial dystrophy and cataract. Cataract surgery followed by DMEK 3 months later were performed in the left eye. RESULTS: Following DMEK, a cleft of interface fluid was documented at the LASIK flap interface via anterior segment optical coherence tomography (AS-OCT) 4 days postoperatively. The DMEK graft was fully attached and intraocular pressure (IOP) was low to normal when the interface fluid was first observed. This interface fluid persisted despite management with IOP-lowering drops. IOP consistently measured low, and the DMEK graft subsequently detached inferiorly. The decision was made to perform Descemet stripping automated endothelial keratoplasty (DSAEK), after which the interface fluid resolved and visual acuity improved significantly. CONCLUSIONS: Interface fluid syndrome can occur years after LASIK, especially following intraocular surgery. This patient may have developed interface fluid syndrome following DMEK due to endothelial dysfunction in the setting of DMEK graft incompetence. Resolution of interface fluid in this patient was achieved after DSAEK. [ Journal of Refractive Surgery Case Reports. 2021;1(1):e15–e18.]

Interface Fluid Syndrome Induced by Scleral Lenses.

Interface Fluid Syndrome Induced by Scleral Lenses.

Multi-drug resistant Burkholderia cepacia keratitis following laser in situ keratomileusis complicated by interface fluid syndrome.

Multi-drug resistant Burkholderia cepacia keratitis following laser in situ keratomileusis complicated by interface fluid syndrome.

Delayed-onset interface fluid syndrome after LASIK following phacotrabeculectomy

BackgroundInterface fluid syndrome (IFS) is an unusual complication after laser-assisted in-situ keratomileusis (LASIK). We report the first case of IFS after uncomplicated phacotrabeculectomy in a patient who had undergone LASIK 10 years previously. This case emphasizes the importance of intraocular pressure (IOP) interpretation in eyes that have undergone LASIK.Case presentationA 30-year-old woman with a history of LASIK surgery presented to glaucoma clinic due to uncontrolled IOP despite of maximally tolerable medical treatment. After receiving phacotrabeculectomy, IOP decreased to 3 mmHg on the first postoperative day, but again increased up to 21 mmHg and a diffuse corneal edema with cloudy flap interface was demonstrated by slit-lamp microscopy. Corneal edema was sustained even after the IOP was lowered to 14 mmHg. Spectral-domain optical coherence tomography scanning of the cornea revealed a diffuse, thin fluid pocket in the corneal interface. After laser lysis of the scleral flap sutures, IOP was further decreased to 9 mmHg and interface fluid was resolved.ConclusionIFS should be considered as a possible cause of postoperative corneal edema despite of low IOP in the eyes that underwent LASIK surgery. Additional IOP lowering may be helpful for resolving the corneal edema.

A late-onset interface fluid syndrome post laser-assisted in situ keratomileusis: Diagnostic and therapeutic challenge

A 43-year-old male underwent laser-assisted in situ keratomileusis and maintained good vision for 9 years. Later, he developed interface fluid syndrome secondary to steroid-induced glaucoma as a consequence of the use of steroids postoperatively for vitrectomy with silicone oil infusion for retinal detachment and cataract surgery.

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

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.

The clinical analysis of corneal interface fluid syndrome after Laser lamellar corneal refractive surgery

Objective: To analysis, the clinical characteristics, refractive changes, and clinical treatment of interface fluid syndrome after laser lamellar corneal refractive surgery. Methods: During Dec. 2010 to Apr. 2016. In total 6 cases(9 eyes), 3 cases were bilateral, 3 cases were unilateral. Five patients were male and 1 was female. The age of the patients ranged from 20 to 29 years was (24.83±4.02) years. Six cases(9 eyes)of IFS were diagnosed at our hospital. The history and complete ophthalmic examination that include Slit-lamp examination, Slit-lamp photography, refraction, corneal thickness measurement, corneal endothelial cell counting, IOP, anterior segment OCT(AS-OCT), exams were recorded. Results: Post-lasik Primary open angle glaucoma was 2 eyes in 1 patient. 1 patient(1 eye)was Posner-Schlossmann Syndrome and 1 patient(1 eye)was iritis after femtosecond laser. Post-small incision lenticule extraction by steroid drops induced elevated IOP were 5 eyes in 3 patients. Slit-lamp exam indicated edematous corneal flap or cap, lamellar haze, interface fluids accumulation. AS-OCT showed obvious interface dark area. The corneal flap or cap thickening and wrinkles, IOP change, diopter myopic shift, Corneal thickening. Conclusions: IFS is a rare but serious complication after Laser lamellar corneal refractive surgery. The main causes are high intraocular pressure and/or dysfunction of corneal endothelium. For patients with high IOP after laser lamellar corneal refractive surgery, follow up should be observed closely. accurate diagnosis by OCT and corneal endothelial cell counting. Early diagnosis, accurate treatment, its prognosis is good. (Chin J Ophthalmol, 2017, 53: 847-854).

Incidence of interface fluid syndrome after laser in situ keratomileusis in Egyptian patients.

PurposeTo determine the incidence of interface fluid syndrome (IFS) secondary to steroid-induced elevation of intraocular pressure (IOP) following laser in situ keratomileusis (LASIK) in myopic Egyptian patients.MethodsThis retrospective case series study was conducted at El-Gowhara Private Eye Center. The medical records of 1,807 patients (3,489 eyes), who underwent LASIK to correct myopia from April 2012 to December 2015 were included. The patients were operated on and reviewed by one surgeon (AAG) for IFS after LASIK associated with elevation of IOP (as compared to preoperative values).ResultsThis paper reports the incidence of 2.9% (54 patients) (102 eyes) of IFS induced by increased IOP after LASIK in Egyptian patients. The medical records of 1,807 patients (3,489 eyes) with mean age ± standard deviation (SD) 26.4±2.7 years, who presented with mean myopia ± SD −4.50±1.3 D, mean astigmatism ± SD −1.43±0.8, mean IOP ± SD 15.2±1.2 mmHg, and mean central corneal thickness ± SD 549±25.6 μm, were included. The preoperative anterior and posterior segments, corneal topography, and Schirmer’s test were unremarkable.ConclusionLimiting topical steroids and routinely measuring the IOP post-LASIK are necessary steps to prevent IFS, especially in case of myopia. A high index of suspicion is required to make a diagnosis. High-resolution optical coherence tomography is helpful to confirm the diagnosis.

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

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.