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Case Reports
. 2010 Jul-Aug;58(4):333-5.
doi: 10.4103/0301-4738.64133.

Misleading Goldmann applanation tonometry in a post-LASIK eye with interface fluid syndrome

Sirisha Senthil  1 , Varsha Rathi, Chandrasekhar Garudadri
Affiliations
Case Reports

Misleading Goldmann applanation tonometry in a post-LASIK eye with interface fluid syndrome

Sirisha Senthil et al. Indian J Ophthalmol. 2010 Jul-Aug.

Abstract

A 21-year-old myope presented with decreased vision and corneal edema following vitreoretinal surgery for retinal detachment. While intraocular pressure (IOP) measurement with Goldmann applanation tonometer (GAT) was low, the digital tonometry indicated raised pressures. An interface fluid syndrome (IFS) was suspected and confirmed by clinical exam and optical coherence tomography. A tonopen used to measure IOP through the peripheral cornea revealed elevated IOP which was the cause of the interface fluid. Treatment with IOP-lowering agents resulted in complete resolution of the interface fluid. This case is being reported to highlight the fact that IFS should be suspected when there is LASIK flap edema and IOP readings using GAT are low and that GAT is not an optimal method to measure IOP in this condition. Alternative methods like tonopen or Schiotz tonometry can be used.

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Figures

Figure 1a
Figure 1a
Slit view of the cornea showing interface fluid
Figure 1b
Figure 1b
Anterior segment OCT showing interface fluid as optically empty space in the flap-stromal interface
Figure 2a
Figure 2a
Slit view of the cornea with resolved interface fluid with well apposed flaps
Figure 2b
Figure 2b
Anterior segment OCT showing no separation of the interface
See this image and copyright information in PMC

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