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

Abstract

Purpose: To 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.

Methods: This 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).

Results: This 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.

Conclusion: Limiting 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.

Keywords: LASIK; diffuse lamellar keratitis; interface fluid; myopia; postoperative complication.

Figure 1

Anterior segment optical coherence tomography of the interface fluid as optical space between the corneal flap and the stroma.

Figure 2

Corneal topography shows thickening of the cornea due to flap edema and interface fluid. Abbreviations: Thk, thickness; Curv, curvature; Rbf, radial basic function; OS, occulus sinister [left eye].