1
|
Tello A, Galvis V, Berrospi RD. Letter Regarding: Interface Fluid Syndrome After Descemet Membrane Endothelial Keratoplasty in Patients With History of LASIK. Cornea 2024; 43:e8-e9. [PMID: 38251919 DOI: 10.1097/ico.0000000000003468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Affiliation(s)
- Alejandro Tello
- Faculty of Health, Department of Ophthalmology, Universidad Autónoma de Bucaramanga (UNAB), Bucaramanga, Colombia
- Centro Oftalmológico Virgilio Galvis, Floridablanca, Colombia
- Department of Ophthalmology, Fundación Oftalmológica de Santander FOSCAL, Floridablanca, Colombia
- Faculty of Health, Department of Surgery, Universidad Industrial de Santander (UIS), Bucaramanga, Colombia
| | - Virgilio Galvis
- Faculty of Health, Department of Ophthalmology, Universidad Autónoma de Bucaramanga (UNAB), Bucaramanga, Colombia
- Centro Oftalmológico Virgilio Galvis, Floridablanca, Colombia
- Department of Ophthalmology, Fundación Oftalmológica de Santander FOSCAL, Floridablanca, Colombia
| | - Ruben D Berrospi
- Faculty of Health, Department of Ophthalmology, Universidad Autónoma de Bucaramanga (UNAB), Bucaramanga, Colombia
- Centro Oftalmológico Virgilio Galvis, Floridablanca, Colombia
- Department of Ophthalmology, Fundación Oftalmológica de Santander FOSCAL, Floridablanca, Colombia
| |
Collapse
|
2
|
Jing X, Congxin L, Xiaoyan Z, Yue Y, Jiao L, Peipei Z, Yirong W, Ying W, Hongsheng B. Interface fluid syndrome caused by the corneal perforation injury after small incision lenticule extraction: a case report. BMC Ophthalmol 2024; 24:117. [PMID: 38481187 PMCID: PMC10938799 DOI: 10.1186/s12886-024-03339-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 02/05/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND To report a case of interface fluid syndrome (IFS) following traumatic corneal perforation repair after small incision lenticule extraction (SMILE). CASE PRESENTATION A 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. CONCLUSIONS This 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.
Collapse
Affiliation(s)
- Xu Jing
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine (TCM), No. 48#, Yingxiongshan Road, 250002, Jinan, P. R. China
| | - Li Congxin
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine (TCM), No. 48#, Yingxiongshan Road, 250002, Jinan, P. R. China
| | - Zhang Xiaoyan
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine (TCM), No. 48#, Yingxiongshan Road, 250002, Jinan, P. R. China
| | - Yuan Yue
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine (TCM), No. 48#, Yingxiongshan Road, 250002, Jinan, P. R. China
| | - Li Jiao
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine (TCM), No. 48#, Yingxiongshan Road, 250002, Jinan, P. R. China
| | - Zu Peipei
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine (TCM), No. 48#, Yingxiongshan Road, 250002, Jinan, P. R. China
| | - Wang Yirong
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine (TCM), No. 48#, Yingxiongshan Road, 250002, Jinan, P. R. China
| | - Wen Ying
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine (TCM), No. 48#, Yingxiongshan Road, 250002, Jinan, P. R. China.
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Academy of Eye Disease Prevention and Therapy, No. 48#, Yingxiongshan Road, 250002, Jinan, P. R. China.
| | - Bi Hongsheng
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine (TCM), No. 48#, Yingxiongshan Road, 250002, Jinan, P. R. China.
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Academy of Eye Disease Prevention and Therapy, No. 48#, Yingxiongshan Road, 250002, Jinan, P. R. China.
| |
Collapse
|
3
|
Chong YJ, Azzopardi M, Hussain G, Recchioni A, Gandhewar J, Loizou C, Giachos I, Barua A, Ting DSJ. Clinical Applications of Anterior Segment Optical Coherence Tomography: An Updated Review. Diagnostics (Basel) 2024; 14:122. [PMID: 38248000 PMCID: PMC10814678 DOI: 10.3390/diagnostics14020122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/28/2023] [Accepted: 01/03/2024] [Indexed: 01/23/2024] Open
Abstract
Since its introduction, optical coherence tomography (OCT) has revolutionized the field of ophthalmology and has now become an indispensable, noninvasive tool in daily practice. Most ophthalmologists are familiar with its use in the assessment and monitoring of retinal and optic nerve diseases. However, it also has important applications in the assessment of anterior segment structures, including the cornea, conjunctiva, sclera, anterior chamber, and iris, and has the potential to transform the clinical examination of these structures. In this review, we aim to provide a comprehensive overview of the potential clinical utility of anterior segment OCT (AS-OCT) for a wide range of anterior segment pathologies, such as conjunctival neoplasia, pterygium, scleritis, keratoconus, corneal dystrophies, and infectious/noninfectious keratitis. In addition, the clinical applications of AS-OCT (including epithelial mapping) in preoperative planning and postoperative monitoring for corneal and refractive surgeries are discussed.
Collapse
Affiliation(s)
- Yu Jeat Chong
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (A.R.); (I.G.); (A.B.)
- Modality Ophthalmology, Modality Partnership, Birmingham B19 1BP, UK;
| | - Matthew Azzopardi
- Department of Ophthalmology, Royal Free Hospital, London NW3 2QG, UK;
| | - Gulmeena Hussain
- University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2GW, UK;
| | - Alberto Recchioni
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (A.R.); (I.G.); (A.B.)
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
| | - Jaishree Gandhewar
- New Cross Hospital, Royal Wolverhampton NHS Trust, Wolverhampton WV10 0QP, UK;
| | | | - Ioannis Giachos
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (A.R.); (I.G.); (A.B.)
| | - Ankur Barua
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (A.R.); (I.G.); (A.B.)
| | - Darren S. J. Ting
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (A.R.); (I.G.); (A.B.)
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
- Academic Ophthalmology, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
| |
Collapse
|
4
|
Altman A, Jaffry M, Dastjerdi MH. Amantadine induced interface fluid formation after LASIK. A case report. Am J Ophthalmol Case Rep 2023; 32:101895. [PMID: 38161515 PMCID: PMC10757172 DOI: 10.1016/j.ajoc.2023.101895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 07/02/2023] [Accepted: 07/19/2023] [Indexed: 01/03/2024] Open
Abstract
Purpose To describe a case of bilateral interface fluid formation 2 years after laser-assisted in situ keratomileusis (LASIK) surgery caused by the side effect of amantadine. Observations A 47-year-old male patient with a history of Parkinson's disease treated with amantadine who had uneventful LASIK surgery in both eyes 2 years ago, presented with a decline in vision over the past 6 weeks. Results: Best corrected vision was 20/200 and 20/400 in the right and left eye respectively. Intraocular pressures were measured within the normal range. Biomicroscopic exam showed bilateral corneal edema. Anterior segment optical coherence tomography (AS-OCT) revealed fluid accumulation within the LASIK flap interface in both corneas. The patient's corneal edema and fluid in the interface began to gradually resolve, and vision improved 2 weeks after discontinuing amantadine. Conclusions and Importance Although there is no previous report, it is possible that amantadine may cause interface fluid formation in patients with LASIK surgery.
Collapse
Affiliation(s)
- Alexander Altman
- Department of Ophthalmology, Rutgers New Jersey Medical School, USA
| | - Mustafa Jaffry
- Department of Ophthalmology, Rutgers New Jersey Medical School, USA
| | | |
Collapse
|
5
|
Izquierdo L, Ben-Shaul O, Larco P, Pereira N, Mannis MJ, Henriquez MA. Interface Fluid Syndrome After Descemet Membrane Endothelial Keratoplasty in Patients With History of LASIK. Cornea 2023; 42:1391-1394. [PMID: 36689681 PMCID: PMC10538602 DOI: 10.1097/ico.0000000000003238] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 12/08/2022] [Accepted: 12/13/2022] [Indexed: 01/24/2023]
Abstract
PURPOSE 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). METHODS 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. RESULTS 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. CONCLUSIONS 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.
Collapse
Affiliation(s)
- Luis Izquierdo
- Research Department, Oftalmosalud Institute of Eyes, Lima, Peru
| | - Or Ben-Shaul
- Department of Ophthalmology, Lady Davis Carmel Medical Center, Haifa, Israel
| | - Pablo Larco
- Research Department, Oftalmosalud Institute of Eyes, Lima, Peru
| | - Nicolas Pereira
- Cornea Department, Sorocaba Eye Bank Hospital, São Paulo, Brazil; and
| | - Mark J. Mannis
- Department of Ophthalmology, University of California at Davis, Davis, CA
| | | |
Collapse
|
6
|
Mokumu D, Hu W, Damaola A, Wu J. Interface fluid syndrome after small incision lenticule extraction surgery secondary to posner schlossman syndrome - A case report. Heliyon 2023; 9:e21863. [PMID: 38027722 PMCID: PMC10663904 DOI: 10.1016/j.heliyon.2023.e21863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 10/17/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose This report describes a case of interface fluid syndrome (IFS) secondary to Posner Schlossman Syndrome (PSS) following small incision lenticule extraction (SMILE) surgery. Case presentation A 19-year-old male was diagnosed with IFS secondary to PSS in his left eye 1 month after undergoing SMILE. Detailed patient history and clinical findings, auxiliary examination results, and short-term follow-up are reported. In this patient, the IFS was caused by elevated intraocular pressure (IOP) due to PSS. Treatment with topical steroids in combination with anti-glaucoma drops led to complete regression of the fluid, and there was no recurrence during a 7-month follow-up period. Conclusion IFS is a potential complication of SMILE, and anterior segment ocular coherence tomography (AS-OCT) can definitively diagnose the condition. This case demonstrates that the treatment for IFS should be based on the underlying cause, and requires prompt and vigorous management for resolution.
Collapse
Affiliation(s)
- Dilinigeer Mokumu
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- The First People's Hospital of Kashi Prefecture, Kashi, Xinjiang, China
| | - Wenfei Hu
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Ailifeire Damaola
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Junshu Wu
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
7
|
Ravipati A, Pradeep T, Donaldson KE. Interface fluid syndrome after LASIK surgery: retrospective pooled analysis and systematic review. J Cataract Refract Surg 2023; 49:885-889. [PMID: 37144645 DOI: 10.1097/j.jcrs.0000000000001214] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 05/01/2023] [Indexed: 05/06/2023]
Abstract
Interface fluid syndrome (IFS) is a complication associated with laser in situ keratomileusis (LASIK) surgery where a fluid pocket in the corneal stroma decreases visual acuity. A systematic review of IFS cases using PRISMA guidelines was performed yielding a total of 33 patients. 2 outcomes were selected for logistic regression analysis: final corrected distance visual acuity (CDVA) and need for surgical management. Results showed 33.3% of patients required surgery, 51.5% had their IFS resolve within 1 month or sooner, and 51.5% had final CDVA 20/25 or better. Higher presenting intraocular pressure (IOP) and duration of IFS ≤1 month was associated with higher odds of final CDVA 20/25 or better (adjusted odds ratio [aOR] 1.12, P = .04; aOR 7.71, P = .02, respectively). Endothelial cell dysfunction led to 17.55 greater odds for requiring surgical compared to medical management (aOR 0.36, P = .04). Presenting IOP and duration of IFS predicted final CDVA, while prior endothelial cell dysfunction predicted need for surgery.
Collapse
Affiliation(s)
- Advaitaa Ravipati
- From the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida (Ravipati, Donaldson); Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania (Pradeep)
| | | | | |
Collapse
|
8
|
LoBue S, Coleman K, Lam P, Shelby C, Coleman WT. Interface Fluid Syndrome Masquerading as Diffuse Lamellar Keratitis After Small Incision Lenticule Extraction. Cureus 2023; 15:e36832. [PMID: 37123732 PMCID: PMC10147493 DOI: 10.7759/cureus.36832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2023] [Indexed: 03/31/2023] Open
Abstract
A 34-year-old male with no past medical or ocular history underwent bilateral uncomplicated small incision lenticule extraction (SMILE). On day 1, uncorrected distance visual acuity (UDVA) was 20/25 in the right eye (OD) and 20/20 in the left eye (OS). The intraocular pressure (IOP) was 12 mmHg in both eyes (OU). On day 17, UDVA was 20/70 OD and 20/30+2 OS. Slit-lamp examination (SLE) revealed diffuse 2+ haze at the interface suspicious for diffuse lamellar keratitis (DLK). Topical difluprednate was added twice a day (BID). Vision decreased by day 20 with a significant myopic shift and 3+ interface haze OU. A washout of the interface was performed. Topical steroids were increased with oral prednisone. One day after the washout, vision and interface haze improved. On day 3 status post washout, UDVA decreased to 20/70 OD and 20/50 OS. IOP was 42 mmHg OU. A diagnosis of interface fluid syndrome (IFS) was confirmed. All steroids were stopped while adding ocular hypotensive medication. One month later, visual acuity was 20/20 OU with a complete resolution of interface haze. Only a handful of IFS has been documented in SMILE, an incidence that may increase as SMILE becomes more common. Among all SMILE cases, IFS was most commonly associated with steroid-induced ocular hypertension and a myopic shift around 21 days postoperatively. A fluid cleft at the interface may not always be visible with SLE, masquerading as DLK. Scheimpflug densitometry and anterior segment optical coherence tomography (AS-OCT) may aid in quantifying interface edema needed to confirm a diagnosis when IOP is unclear. A corneal washout can immediately improve corneal edema, but the preferred treatment is discontinuing all steroid medication and starting glaucoma drops.
Collapse
|
9
|
Treatment of interface fluid syndrome after laser in situ keratomileusis with Descemet's membrane endothelial keratoplasty in a patient with corneal endothelial dysfunction. J Fr Ophtalmol 2023; 46:e64-e66. [PMID: 36682954 DOI: 10.1016/j.jfo.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/11/2022] [Accepted: 08/26/2022] [Indexed: 01/21/2023]
|
10
|
Moura-Coelho N, Arrondo E, Papa-Vettorazzi MR, Cunha JP, Güell JL. DMEK for the treatment of interface fluid syndrome secondary to failed DSAEK graft: A case report and review of the literature. Am J Ophthalmol Case Rep 2022; 27:101656. [PMID: 35865659 PMCID: PMC9294039 DOI: 10.1016/j.ajoc.2022.101656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/29/2022] [Accepted: 06/30/2022] [Indexed: 11/03/2022] Open
Abstract
Purpose Observations Conclusions and Importance
Collapse
|
11
|
Koronis S, Diafas A, Tzamalis A, Samouilidou M, Mataftsi A, Ziakas N. Late-onset interface fluid syndrome: A case report and literature review. Semin Ophthalmol 2022; 37:839-848. [PMID: 35866219 DOI: 10.1080/08820538.2022.2102928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE To present a case of late-onset interface fluid syndrome (IFS) and a literature review on this rare clinical entity. INTRODUCTION IFS is an uncommon complication of laser in situ keratomileusis (LASIK). Although generally appearing in the early postoperative period, IFS has been reported even years after LASIK. METHODS A case report of IFS manifesting 19 years after uneventful LASIK, which prompted a literature search for similar, late-onset cases in MEDLINE PubMed. This article reports on a case of IFS appearing 19 years after LASIK surgery, including extensive patient history and analytical presentation of clinical findings, ancillary testing, and short-term follow-up. Furthermore, a literature search for similar cases was performed on MEDLINE, focusing on the etiology and management of late-onset IFS. RESULTS Through thorough ancillary testing, the interface fluid was attributed to elevated intraocular pressure (IOP) arising from primary open-angle glaucoma. Antiglaucoma drops resulted in complete fluid regression. A narrative review was conducted based on the 29 case reports that were recovered from the literature search. CONCLUSION IFS represents an uncommon complication that could appear years after LASIK. Careful clinical examination and anterior segment optical coherence tomography promote early diagnosis. Similar cases may manifest due to elevated IOP of variable etiology or as a result of endothelial dysfunction. Depending on the etiology, IOP control or keratoplasty may resolve the condition.
Collapse
Affiliation(s)
- Spyridon Koronis
- 2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Asterios Diafas
- 2 Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece.,St Paul's Eye Unit, Royal Liverpool University Hotel, Liverpool, UK
| | - Argyrios Tzamalis
- 2 Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Maria Samouilidou
- 2 Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Asimina Mataftsi
- 2 Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Nikolaos Ziakas
- 2 Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| |
Collapse
|
12
|
Ducray V, Baudin F, de Bosredon Q, Theillac V, Creuzot-Garcher C, Arnould L. Syndrome de fluide dans l’interface secondaire à un traumatisme contusif chez un patient aux antécédents de chirurgie réfractive par femtoLASIK. J Fr Ophtalmol 2022; 45:e265-e267. [DOI: 10.1016/j.jfo.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/13/2021] [Indexed: 10/19/2022]
|
13
|
Pan BX, Margeta MA. Elevated Intraocular Pressure in a Young Man With a History of Laser-Assisted In Situ Keratomileusis. JAMA Ophthalmol 2019; 137:318-319. [PMID: 30605216 DOI: 10.1001/jamaophthalmol.2018.5430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Billy X Pan
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston
| | - Milica A Margeta
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston
| |
Collapse
|
14
|
Sánchez-Barahona C, Bolívar G, Mikropoulos DG, Konstas AG, Teus MA. Effect of Acute Increases in Intraocular Pressure on Corneal Pachymetry in Rabbit Eyes Treated with Timolol Maleate. Open Ophthalmol J 2018. [DOI: 10.2174/1874364101812010314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective:
To evaluate in an in vivo rabbit model, the effect of topical timolol maleate therapy on the central corneal thickness response to acute intraocular pressure increases.
Method:
In this prospective and interventional controlled study, the central corneal thickness and intraocular pressure were measured in vivo in 12 rabbit eyes treated with topical timolol maleate for 1 month and in 12 controls at baseline, and after the intraocular pressure (measured by direct cannulation of the anterior chamber) was increased to 15 and 30 mmHg using a forced saline infusion into the anterior chamber.
Results:
There were no significant differences in the basal central corneal thickness values (control group, 373.2±12.9 µm; study group, 377.5±19.2 µm, p=0.5) or the central corneal thickness values when the intraocular pressure was increased to 15 mmHg (control group, 335.2±14.3 µm; study group, 330.0±32.1 µm, p=0.6) and to 30 mmHg (study group, 318.8±25.3 µm; control group, 329.8±21.0 µm, p=0.3).
Conclusion:
Rabbit corneas treated with topical timolol maleate for 1 month did not show a strain response to acute intraocular pressure increases that differed from control eyes. This is in contrast to a previous finding in which rabbit eyes treated with prostaglandin analogues had a greater decrease in central corneal thickness in response to a sudden intraocular pressure increase compared with untreated corneas.
Collapse
|
15
|
Kasım B, Koçluk Y, Burcu A. Interface fluid syndrome secondary to endothelial failure due to toxic anterior segment syndrome after cataract surgery. Eur J Ophthalmol 2018; 29:NP1-NP4. [DOI: 10.1177/1120672118800241] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: To present a case of previous laser in situ keratomileusis with interface fluid syndrome secondary to toxic anterior segment syndrome following cataract surgery. Case report: A 52-year-old woman, complaining blurred vision in her right eye for 18 months after cataract surgery, was referred to our clinic. She was diagnosed with toxic anterior segment syndrome, postoperatively, which resolved in 3 days. She had a history of laser in situ keratomileusis surgery 15 years ago. Slit-lamp examination of the right eye showed corneal haze, limited to laser in situ keratomileusis flap. The patient was diagnosed with interface fluid syndrome secondary to endothelial decompensation due to toxic anterior segment syndrome. Descemet’s membrane endothelial keratoplasy was performed along with full thickness fenestrations in the laser in situ keratomileusis flap to the right eye of the patient. The fluid was resolved in 1 week and visual acuity was improved rapidly. Conclusion: This case shows the importance of considering the diagnosis and determining the specific etiology of interface fluid syndrome, even years after the laser in situ keratomileusis surgery, when endothelial cell function has been compromised with any factor, such as intraocular surgery and its complications.
Collapse
Affiliation(s)
- Burcu Kasım
- Department of Ophthalmology, Adana City Training and Research Hospital, Adana, Turkey
| | - Yusuf Koçluk
- Department of Ophthalmology, Adana City Training and Research Hospital, Adana, Turkey
| | - Ayşe Burcu
- Department of Ophthalmology, Ankara Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
16
|
Cabral-Macias J, García-De la Rosa G, Rodríguez-Matilde DF, Vela-Barrera ID, Ledesma-Gil J, Ramirez-Miranda A, Graue-Hernandez EO, Navas A. Pressure-induced stromal keratopathy after laser in situ keratomileusis: Acute and late-onset presentations. J Cataract Refract Surg 2018; 44:1284-1290. [PMID: 30107965 DOI: 10.1016/j.jcrs.2018.06.053] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 06/21/2018] [Accepted: 06/22/2018] [Indexed: 12/17/2022]
Abstract
We present a series of 4 cases of pressure-induced stromal keratopathy after laser in situ keratomileusis (LASIK). Four patients (5 eyes) with previous LASIK presented for poor visual acuity and ocular pain because of ocular hypertension. At examination, all cases revealed corneal haze and a space filled with fluid between the surgical flap and the residual stroma. All cases were managed with topical hypotensive treatment and one of them was also treated with a valve drainage device. Topical steroids restriction was indicated in all cases. Intraocular pressure (IOP) was normalized in all cases with subsequent interface fluid resolution and significant improvement of vision in most cases. Early recognition and appropriate treatment for pressure-induced stromal keratopathy is essential to avoid complications associated with prolonged elevated IOP. It is extremely important to measure the IOP in the peripheral cornea because IOP in the central cornea can be incorrectly measured with the characteristic interface fluid developed in this entity.
Collapse
Affiliation(s)
- Jesus Cabral-Macias
- From the Department of Cornea and Refractive Surgery (Cabral-Macias, García-De la Rosa, Rodríguez-Matilde, Vela-Barrera, Ramirez-Miranda, Graue-Hernandez, Graue-Hernandez) and the Department of Glaucoma (Ledesma-Gil), Instituto de Oftalmología Conde de Valenciana, Mexico City, Mexico
| | - Guillermo García-De la Rosa
- From the Department of Cornea and Refractive Surgery (Cabral-Macias, García-De la Rosa, Rodríguez-Matilde, Vela-Barrera, Ramirez-Miranda, Graue-Hernandez, Graue-Hernandez) and the Department of Glaucoma (Ledesma-Gil), Instituto de Oftalmología Conde de Valenciana, Mexico City, Mexico
| | - Diana F Rodríguez-Matilde
- From the Department of Cornea and Refractive Surgery (Cabral-Macias, García-De la Rosa, Rodríguez-Matilde, Vela-Barrera, Ramirez-Miranda, Graue-Hernandez, Graue-Hernandez) and the Department of Glaucoma (Ledesma-Gil), Instituto de Oftalmología Conde de Valenciana, Mexico City, Mexico
| | - Ivan Daryl Vela-Barrera
- From the Department of Cornea and Refractive Surgery (Cabral-Macias, García-De la Rosa, Rodríguez-Matilde, Vela-Barrera, Ramirez-Miranda, Graue-Hernandez, Graue-Hernandez) and the Department of Glaucoma (Ledesma-Gil), Instituto de Oftalmología Conde de Valenciana, Mexico City, Mexico
| | - Jasbeth Ledesma-Gil
- From the Department of Cornea and Refractive Surgery (Cabral-Macias, García-De la Rosa, Rodríguez-Matilde, Vela-Barrera, Ramirez-Miranda, Graue-Hernandez, Graue-Hernandez) and the Department of Glaucoma (Ledesma-Gil), Instituto de Oftalmología Conde de Valenciana, Mexico City, Mexico
| | - Arturo Ramirez-Miranda
- From the Department of Cornea and Refractive Surgery (Cabral-Macias, García-De la Rosa, Rodríguez-Matilde, Vela-Barrera, Ramirez-Miranda, Graue-Hernandez, Graue-Hernandez) and the Department of Glaucoma (Ledesma-Gil), Instituto de Oftalmología Conde de Valenciana, Mexico City, Mexico
| | - Enrique O Graue-Hernandez
- From the Department of Cornea and Refractive Surgery (Cabral-Macias, García-De la Rosa, Rodríguez-Matilde, Vela-Barrera, Ramirez-Miranda, Graue-Hernandez, Graue-Hernandez) and the Department of Glaucoma (Ledesma-Gil), Instituto de Oftalmología Conde de Valenciana, Mexico City, Mexico
| | - Alejandro Navas
- From the Department of Cornea and Refractive Surgery (Cabral-Macias, García-De la Rosa, Rodríguez-Matilde, Vela-Barrera, Ramirez-Miranda, Graue-Hernandez, Graue-Hernandez) and the Department of Glaucoma (Ledesma-Gil), Instituto de Oftalmología Conde de Valenciana, Mexico City, Mexico.
| |
Collapse
|
17
|
Galvis V, Berrospi RD, Tello A, Santaella G. Interface Fluid Syndrome (IFS) following Toxic Anterior Segment Syndrome (TASS): not related to high intraocular pressure but to endothelial failure. Saudi J Ophthalmol 2018; 33:88-93. [PMID: 30930670 PMCID: PMC6424685 DOI: 10.1016/j.sjopt.2018.06.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 06/29/2018] [Indexed: 11/19/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Virgilio Galvis
- Centro Oftalmológico Virgilio Galvis, Floridablanca, Colombia
- Fundación Oftalmológica de Santander FOSCAL, Floridablanca, Colombia
- Universidad Autónoma de Bucaramanga, Faculty of Health Sciences, Bucaramanga, Colombia
| | - Rubén D. Berrospi
- Centro Oftalmológico Virgilio Galvis, Floridablanca, Colombia
- Fundación Oftalmológica de Santander FOSCAL, Floridablanca, Colombia
| | - Alejandro Tello
- Centro Oftalmológico Virgilio Galvis, Floridablanca, Colombia
- Fundación Oftalmológica de Santander FOSCAL, Floridablanca, Colombia
- Universidad Autónoma de Bucaramanga, Faculty of Health Sciences, Bucaramanga, Colombia
- Corresponding author at: Centro Oftalmológico Virgilio Galvis, Centro Médico Ardila Lulle, Module 7, Floor 3, El Bosque, Floridablanca, Santander, Colombia. Fax: +57 7 6392626.
| | | |
Collapse
|
18
|
Jia Z, Zhao S, Wei R, Huang Y, Zhang C, Yang R. Interface fluid syndrome: A potential lifelong complication after LASIK. A case report. Am J Ophthalmol Case Rep 2018; 11:23-25. [PMID: 30073213 PMCID: PMC6069574 DOI: 10.1016/j.ajoc.2018.04.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 03/24/2018] [Accepted: 04/17/2018] [Indexed: 12/26/2022] Open
Abstract
Purpose To describe a case of interface fluid formation caused by uncontrollable intraocular pressure (IOP) 16 years after laser-assisted in situ keratomileusis (LASIK) surgery secondary to Posner Schlossman Syndrome (PSS). Observations After trabeculectomy operation, IOP of the operative eye was back to normal, and the interface fluid refluxed over time. Conclusions and importance: Interface Fluid Syndrome can be a potential lifelong complication after LASIK surgery. PSS patients post-LASIK require early IOP control.
Collapse
Affiliation(s)
| | - Shaozhen Zhao
- Corresponding author. Tianjin Medical University Eye Hospital & Eye Institute, No. 251, Fukang R., Nankai District, Tianjin, 300384, China.
| | | | | | | | | |
Collapse
|
19
|
Murueta-Goyena A, Cañadas P. Visual outcomes and management after corneal refractive surgery: A review. JOURNAL OF OPTOMETRY 2018; 11:121-129. [PMID: 29183707 PMCID: PMC5904824 DOI: 10.1016/j.optom.2017.09.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 09/18/2017] [Accepted: 09/19/2017] [Indexed: 05/04/2023]
Abstract
Corneal refractive surgery procedures are widely performed to permanently correct refractive errors. Overall, refractive surgeries are safe, predictable and present high rates of satisfaction. Nevertheless, the induced epithelial, stromal and nerve damage alters corneal integrity and function, triggering a regenerative response. Complications that arise from corneal wound healing process might directly impact on visual outcomes of keratorefractive procedures. Most of these complications can be prevented or effectively treated with minimal consequences and minor impact on optical quality. Nevertheless, it is crucial to accurately and timely identify these corneal regeneration-related complications for successful counseling and management. Optometrists, as primary eye care providers, play an essential role in detecting anatomic and functional alterations in vision. It is therefore of great interest for optometrists to be familiar with the principal postoperative complications derived from alterations in regenerative process after corneal laser refractive surgeries. This review aims to provide a basis for optometrists to better understand, identify and manage the main wound healing-related complications after refractive surgery.
Collapse
Affiliation(s)
- Ane Murueta-Goyena
- Deparment of Neuroscience, University of the Basque Country (UPV/EHU), Leioa, Spain.
| | - Pilar Cañadas
- Instituto de Oftalmobiología Aplicada (IOBA) Grupo de Superficie Ocular, Universidad de Valladolid, Valladolid, Spain; Departamento de Física Teórica Atómica y Óptica, Universidad de Valladolid, Valladolid, Spain
| |
Collapse
|
20
|
Abstract
PURPOSE OF REVIEW Given the popularity of keratorefractive surgery, and an aging populous of patients who have undergone these procedures, there is an increasing need for updated management protocols. This is particularly relevant for patients with chronic progressive diseases such as glaucoma, due to the variety of related diagnostic and management challenges inherent to these diseases. Here, we will review the current literature to provide an update on the management of patients with glaucoma who are undergoing, or have had laser ablative refractive surgery. Preoperative testing and eligibility considerations, intraoperative factors, and postoperative observation and follow-up will be discussed. RECENT FINDINGS Intraoperative intraocular pressure (IOP) rise during flap creation is associated with low risk of acute complications, and furthermore do not appear to have significant long term effects. Modern technologies have improved our ability to determine accurate IOP after refractive surgery despite postoperative changes in corneal architecture. Furthermore, advances in structural imaging allow for earlier detection of even subtle glaucomatous nerve damage. SUMMARY Although glaucoma remains a relative contraindication to refractive surgery, it is a safe procedure for many patients with appropriate perioperative management and follow-up. Advancements in diagnostic modalities have allowed for earlier detection of glaucomatous disease, and subsequent earlier intervention when appropriate. Standardized diagnostic algorithms and rigorous perioperative assessment are critical to safe management of glaucoma patients undergoing refractive corneal surgery.
Collapse
|
21
|
Zheng K, Han T, Li M, Han Y, Xu Y, Shah R, Zhou X. Corneal densitometry changes in a patient with interface fluid syndrome after small incision lenticule extraction. BMC Ophthalmol 2017; 17:34. [PMID: 28356099 PMCID: PMC5372330 DOI: 10.1186/s12886-017-0428-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 03/20/2017] [Indexed: 11/10/2022] Open
Abstract
Background To report a case of interface fluid syndrome (IFS) following small incision lenticule extraction (SMILE) evaluated with corneal densitometry and optical coherence tomography (OCT). Case presentation An 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. Conclusion This 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.
Collapse
Affiliation(s)
- Ke Zheng
- Key Lab of Myopia, Ministry of Health, Department of Ophthalmology and Vision Science, Eye and ENT Hospital of Fudan University, No.19 Baoqing Road, Xuhui District, Shanghai, China
| | - Tian Han
- Key Lab of Myopia, Ministry of Health, Department of Ophthalmology and Vision Science, Eye and ENT Hospital of Fudan University, No.19 Baoqing Road, Xuhui District, Shanghai, China
| | - Meiyan Li
- Key Lab of Myopia, Ministry of Health, Department of Ophthalmology and Vision Science, Eye and ENT Hospital of Fudan University, No.19 Baoqing Road, Xuhui District, Shanghai, China
| | - Yinan Han
- Key Lab of Myopia, Ministry of Health, Department of Ophthalmology and Vision Science, Eye and ENT Hospital of Fudan University, No.19 Baoqing Road, Xuhui District, Shanghai, China
| | - Ye Xu
- Key Lab of Myopia, Ministry of Health, Department of Ophthalmology and Vision Science, Eye and ENT Hospital of Fudan University, No.19 Baoqing Road, Xuhui District, Shanghai, China
| | - Rupal Shah
- New Vision Laser Centers, Vadodara, Gujarat, India
| | - Xingtao Zhou
- Key Lab of Myopia, Ministry of Health, Department of Ophthalmology and Vision Science, Eye and ENT Hospital of Fudan University, No.19 Baoqing Road, Xuhui District, Shanghai, China.
| |
Collapse
|
22
|
Interface Fluid Syndrome After Laser In Situ Keratomileusis (LASIK) Because of Fuchs Endothelial Dystrophy Reversed by Descemet Membrane Endothelial Keratoplasty (DMEK). Cornea 2016; 35:1658-1661. [DOI: 10.1097/ico.0000000000000971] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
23
|
LASIK Interface Complications: Pressure-induced Stromal Keratitis (PISK), Interface Fluid Syndrome (IFS) and Post-LASIK Edema-induced Keratopathy (PLEK). Int Ophthalmol Clin 2016; 56:185-7. [PMID: 27257731 DOI: 10.1097/iio.0000000000000129] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
24
|
Kanellopoulos AJ, Cruz EM, Ang RET, Asimellis G. Higher incidence of steroid-induced ocular hypertension in keratoconus. EYE AND VISION 2016; 3:4. [PMID: 26909354 PMCID: PMC4763428 DOI: 10.1186/s40662-016-0035-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 01/24/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND To compare intraocular pressure (IOP) changes following topical dexamethasone administration for 1 month in keratoconic versus normal eyes. METHODS This is a retrospective, single-center, non-randomized case series evaluation of 350 eyes. Two groups were formed: normal/control Group A (nA =73), eyes that underwent excimer laser photorefractive keratectomy; and keratoconic (KCN) Group B (nB =277), eyes that were subjected to partial laser photorefractive keratectomy combined with collagen cross-linking (The Athens Protocol). All eyes received the same post-operative regimen of topical dexamethasone 0.1 % for at least 1 month. Goldmann applanation tonometry IOP readings and central corneal thickness (CCT) measurements were monitored. Cases with induced ocular hypertension (OHT, defined as post-operative IOP higher than 21 mmHg), were identified and correlated to refractive procedure, gender, and corneal thickness. RESULTS At 4 weeks postoperatively, OHT was noted on 27.4 % (20 /73 eyes) in Group A, and 43.7 % (121 /277 eyes) in KCN Group B, (p <0.01). Six months post-operatively (following 5-months of discontinuing topical dexamethasone treatment and commencing treatment of IOP-lowering medications), OHT rate was 1.8 % in Group A and 3.9 % in the KCN Group B. CONCLUSION This study demonstrates a potentially significant pre-disposition of keratoconic eyes to the development of steroid-induced OHT.
Collapse
Affiliation(s)
- Anastasios John Kanellopoulos
- Laservision.gr Clinical and Research Eye Institute, 17 Tsocha Street, Athens, Postal Code: 11521 Greece ; NYU Medical School, New York, NY USA
| | - Emerson M Cruz
- Laservision.gr Clinical and Research Eye Institute, 17 Tsocha Street, Athens, Postal Code: 11521 Greece ; Asian Eye Institute, Makati, Philippines
| | | | - George Asimellis
- Laservision.gr Clinical and Research Eye Institute, 17 Tsocha Street, Athens, Postal Code: 11521 Greece
| |
Collapse
|
25
|
Shoji N, Ishida A, Haruki T, Matsumura K, Kasahara M, Shimizu K. Interface Fluid Syndrome Induced by Uncontrolled Intraocular Pressure Without Triggering Factors After LASIK in a Glaucoma Patient: A Case Report. Medicine (Baltimore) 2015; 94:e1609. [PMID: 26426645 PMCID: PMC4616883 DOI: 10.1097/md.0000000000001609] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
This study sought to describe a glaucoma patient with interface fluid syndrome (IFS) induced by uncontrolled intraocular pressure (IOP) without triggering factors after laser in situ keratomileusis (LASIK). Case report and review of the literature. A 23-year-old man with open-angle glaucoma underwent bilateral LASIK for myopia in 2009. Two years later, the patient reported sudden vision loss. The IOP in the right eye was not measurable using Goldmann applanation tonometry (GAT), but was determined to be 33.7 mm Hg using a noncontact tonometer. IFS was diagnosed based on the presence of space-occupying interface fluid on anterior segment optical coherence tomography images. After a trabeculectomy was performed, the IOP decreased to 10 mm Hg, and GAT measurement became possible. However, the corneal fold remained visible in the flap interface. Six months later, the IOP in the left eye increased, and a trabeculectomy was performed during the early stages of this increase in IOP. Following this procedure, the IOP decreased, and visual acuity remained stable. In glaucoma cases that involve a prior increase in IOP, IOP can continue to increase during the disease course even if temporary control of IOP has been achieved. If LASIK is performed in such cases, the treatment of glaucoma becomes insufficient because of underestimation of the typical IOP. In fact, the measurement of IOP can become difficult because of high-IOP levels. Therefore, LASIK should not be performed on patients with glaucoma who are at high risk of elevated IOP.
Collapse
Affiliation(s)
- Nobuyuki Shoji
- From the Orthoptics and Visual Science Course (NS), Kitasato University School of Allied Health Sciences; and Department of Ophthalmology (NS, AI, TH, KM, MK, KS), Kitasato University Hospital, Kanagawa, Japan
| | | | | | | | | | | |
Collapse
|
26
|
Gros-Otero J, Garcia-Gonzalez M, Teus MA. Transient corneal edema circumscribed to the LASIK flap after uneventful cataract surgery. Can J Ophthalmol 2015; 50:e17-9. [DOI: 10.1016/j.jcjo.2014.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Revised: 11/02/2014] [Accepted: 11/05/2014] [Indexed: 11/16/2022]
|
27
|
Pajic B, Vastardis I, Pajic-Eggspuehler B, Gatzioufas Z, Hafezi F. Femtosecond laser versus mechanical microkeratome-assisted flap creation for LASIK: a prospective, randomized, paired-eye study. Clin Ophthalmol 2014; 8:1883-9. [PMID: 25284975 PMCID: PMC4181739 DOI: 10.2147/opth.s68124] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To compare a femtosecond laser with a microkeratome for flap creation during laser in situ keratomileusis (LASIK) in terms of flap thickness predictability and visual outcomes. Patients and methods This was a prospective, randomized, masked, paired-eye study. Forty-four patients (34 females) who received bilateral LASIK were included. Patients were stratified by ocular dominance, and they then underwent randomization of flap creation using the femtosecond laser on one eye and undergoing the microkeratome procedure on the other one. The visual outcome differences between the corrected distance visual acuity (CDVA) at baseline and the uncorrected distance visual acuity (UDVA) on the first day postoperatively were set as the efficiency index for both groups. All visual acuity outcome results and the deviation of flap thickness were evaluated. P-values <0.05 were considered statistically significant. Results The index of efficiency regarding the postoperative visual outcomes in the microkeratome group was lower (P<0.0001). This result was correlated with the difference between intended and achieved flap thickness (P=0.038; r=0.28), and a negative relationship in the regression analysis was confirmed (P<0.04; R2=0.1428). The UDVA in the microkeratome group improved significantly by the end of the first month (P<0.0271) in comparison to the baseline CDVA. The deviation between intended and postoperative flap thickness using either optical coherence pachymetry or Heidelberg Retinal Tomography II confocal microscopy was statistically significant (paired t-test; P<0.001) between the groups. The flap thickness deviation in the microkeratome group was higher. In the femtosecond laser group, the efficiency index was stable postoperatively (P=0.64) The UDVA improved significantly by the end of the first postoperative week (P=0.0043) in comparison to the baseline CDVA. Six months after surgery, improvement in the UDVA was significant in both groups (all P<0.001; one way analysis of variance). Conclusion Femtosecond laser was superior to microkeratome-assisted LASIK in terms of flap thickness predictability and the speed of visual acuity recovery. A negative relationship in the regression analysis between increasing flap thickness deviation and visual acuity recovery was confirmed.
Collapse
Affiliation(s)
- Bojan Pajic
- Swiss Eye Research Foundation, Eye Clinic ORASIS, Reinach, Switzerland ; Division of Ophthalmology, Department of Clinical Neurosciences, University Hospital of Geneva, Geneva, Switzerland ; Eye Hospital VIDAR-ORASIS Swiss, University of Novi Sad, Faculty of Physics, Novi Sad, Serbia ; Military Medical Academy, University of Defense, Belgrade, Serbia
| | - Iraklis Vastardis
- Swiss Eye Research Foundation, Eye Clinic ORASIS, Reinach, Switzerland ; Eye Hospital VIDAR-ORASIS Swiss, University of Novi Sad, Faculty of Physics, Novi Sad, Serbia
| | | | - Zisis Gatzioufas
- Division of Ophthalmology, Department of Clinical Neurosciences, University Hospital of Geneva, Geneva, Switzerland
| | - Farhad Hafezi
- Division of Ophthalmology, Department of Clinical Neurosciences, University Hospital of Geneva, Geneva, Switzerland ; Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
28
|
Jung HG, Lee JR, Lee SU, Kim YD. Delayed-Onset Interface Fluid Syndrome after LASIK Surgery in Traumatic Hyphema. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2014. [DOI: 10.3341/jkos.2014.55.1.129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
| | - Jong Rak Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | | | | |
Collapse
|
29
|
Abstract
PURPOSE To compare anterior and posterior corneal curvatures between eyes with primary open-angle glaucoma (POAG) and healthy eyes. METHODS This is a prospective, cross-sectional, observer-masked study. A total of 138 white subjects (one eye per patient) were consecutively recruited; 69 eyes had POAG (study group), and the other 69 comprised a group of healthy control eyes matched for age and central corneal pachymetry with the study ones. Exclusion criteria included any corneal or ocular inflammatory disease, previous ocular surgery, or treatment with carbonic anhydrase inhibitors. The same masked observer performed Goldmann applanation tonometry, ultrasound pachymetry, and Orbscan II topography in all cases. Central corneal thickness, intraocular pressure, and anterior and posterior topographic elevation maps were analyzed and compared between both groups. RESULTS Patients with POAG had greater forward shifting of the posterior corneal surface than that in healthy control eyes (p < 0.01). Significant differences in anterior corneal elevation between controls and POAG eyes were also found (p < 0.01). CONCLUSIONS Primary open-angle glaucoma eyes have a higher elevation of the posterior corneal surface than that in central corneal thickness-matched nonglaucomatous eyes.
Collapse
|
30
|
Interface fluid syndrome after laser in situ keratomileusis following herpetic keratouveitis. J Cataract Refract Surg 2013; 39:1267-70. [DOI: 10.1016/j.jcrs.2013.04.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Revised: 03/11/2013] [Accepted: 03/11/2013] [Indexed: 11/23/2022]
|
31
|
Abstract
PURPOSE To describe a patient with pressure-induced interlamellar stromal keratitis after complicated vitreoretinal surgery, occurring 7 years after myopic laser in situ keratomileusis. METHODS Case report and review of the literature. RESULTS A 45-year-old man presented with increasing pain and blurring of vision in his left eye 3 weeks after vitreoretinal surgery for rhegmatogenous retinal detachment. This was associated with diffuse corneal stromal haze and raised intraocular pressure. An anterior segment optical coherence tomography revealed fluid between the laser in situ keratomileusis flap and the residual stromal bed. CONCLUSION Pressure-induced interlamellar stromal keratitis can occur many years after laser in situ keratomileusis. The clinical presentation mimics that of diffuse lamellar keratitis, but corneal haze may be absent in the early stages. Once diagnosed, the intraocular pressure should be managed aggressively to prevent the development of irreversible glaucomatous optic neuropathy.
Collapse
|
32
|
Galvis V, Tello A, Revelo ML, Valarezo P. LASIK interface complications: what is the appropriate term for PISK? J Refract Surg 2013; 29:81. [PMID: 23380406 DOI: 10.3928/1081597x-20130108-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
33
|
Galvis V, Tello A, Revelo ML, Valarezo P. Post-LASIK edema-induced keratopathy (PLEK), a new name based on pathophysiology of the condition. BMJ Case Rep 2012; 2012:bcr-2012-007328. [PMID: 23112265 DOI: 10.1136/bcr-2012-007328] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 33-year-old man who underwent uneventful laser in situ keratomileusis (LASIK) developed pressure-induced stromal edema resulting in an interface haze in both eyes and a pocket of fluid under the flap of the right eye 10 days after surgery, while receiving topical fluorometholone. Intraocular pressure by applanation tonometry was 16 mm Hg in his right eye (erroneous result due to the fluid in the interface) and 34 mm Hg in his left eye. After discontinuation of steroids and addition of ocular hypotensive medication, interface fluid collection disappeared in his right eye. Visual acuity improved and haze diminished in both eyes. This case illustrates that in the same patient a post-LASIK edema induced syndrome may be present with or without fluid in the interface, suggesting that both clinical pictures could be manifestations of a broad spectrum of the same condition. We suggest a new name for this non-inflammatory disorder: post-LASIK edema-induced keratopathy (PLEK).
Collapse
Affiliation(s)
- Virgilio Galvis
- Department of Ophthalmology, Centro Oftalmologico Virgilio Galvis, Floridablanca, Santander, Colombia
| | | | | | | |
Collapse
|
34
|
Randleman JB, Shah RD. LASIK interface complications: etiology, management, and outcomes. J Refract Surg 2012; 28:575-86. [PMID: 22869235 DOI: 10.3928/1081597x-20120722-01] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Accepted: 07/16/2012] [Indexed: 01/31/2023]
Abstract
PURPOSE To describe the etiology, diagnosis, clinical course, and management of LASIK interface complications. METHODS Literature review. RESULTS Primary interface complications include infectious keratitis, diffuse lamellar keratitis, central toxic keratopathy, pressure-induced stromal keratopathy (PISK), and epithelial ingrowth. Infectious keratitis is most commonly caused by Methicillin-resistant Staphylococcus aureus (early onset) or atypical Mycobacterium (late onset) postoperatively, and immediate treatment includes flap lift and irrigation, cultures, and initiation of broad-spectrum topical antibiotics, with possible flap amputation for recalcitrant cases. Diffuse lamellar keratitis is a white blood cell infiltrate that appears within the first 5 days postoperatively and is acutely responsive to aggressive topical and oral steroid use in the early stages, but may require flap lift and irrigation to prevent flap necrosis if inflammation worsens. In contrast, PISK is caused by acute steroid response and resolves only with cessation of steroid use and intraocular pressure lowering. Without appropriate therapy PISK can result in severe optic nerve damage. Central toxic keratopathy mimics stage 4 diffuse lamellar keratitis, but occurs early in the postoperative period and is noninflammatory. Observation is the only effective treatment, and flap lift is usually not warranted. Epithelial ingrowth is easily distinguishable from other interface complications and may be self-limited or require flap lift to treat irregular astigmatism and prevent flap melt. CONCLUSIONS Differentiating between interface entities is critical to rapid appropriate diagnosis, treatment, and ultimate visual outcome. Although initial presentations may overlap significantly, the conditions can be readily distinguished with close follow-up, and most complications can resolve without significant visual sequelae when treated appropriately.
Collapse
Affiliation(s)
- J Bradley Randleman
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA.
| | | |
Collapse
|
35
|
Interface Fluid Syndrome in Routine Cataract Surgery 10 Years After Laser In Situ Keratomileusis. Cornea 2012; 31:706-7. [DOI: 10.1097/ico.0b013e3182254020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
36
|
Carreño E, Portero A, Galarreta DJ, Merayo JM. Interface fluid syndrome associated with cataract surgery. J Refract Surg 2012; 28:243-4. [PMID: 22496435 DOI: 10.3928/1081597x-20120308-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
37
|
Fan Q, Zhang J, Zheng L, Feng H, Wang H. Intraocular pressure change after myopic laser in situ keratomileusis as measured on the central and peripheral cornea. Clin Exp Optom 2012; 95:421-6. [PMID: 22443896 DOI: 10.1111/j.1444-0938.2011.00703.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Laser in situ keratomileusis (LASIK) leads to inaccurate measurement of intraocular pressure (IOP). This study aimed to determine the efficacy and reliability of IOP measurement on the peripheral cornea after LASIK. METHODS The IOP was measured in 52 eyes of 26 subjects before LASIK and one week and one month after LASIK using non-contact tonometry. The measurements were made on the central and peripheral cornea and the results were subjected to statistical analysis. RESULTS The mean measured IOP on the central cornea was decreased by 6.425 ± 2.544 mmHg at one week and 5.752 ± 3.863 mmHg at one month post-operatively. The mean IOP measured on the peripheral cornea was decreased by only 0.921 ± 2.054 mmHg at one week post-operatively. Most notably, the mean IOP measured on the peripheral cornea was increased by only 0.158 ± 2.979 mmHg at one month post-operatively with no statistical significance (p > 0.05). Furthermore, a linear regression of ablation depth versus change in IOP measured on the central cornea was demonstrated, but the peripheral IOP did not display such a statistically significant correlation with the depth of ablation at both one week and one month after operation. CONCLUSION The IOP measured on the peripheral cornea is closer to the actual IOP. Therefore, it is more accurate and reliable to measure IOP on the peripheral cornea than on the centre after LASIK.
Collapse
Affiliation(s)
- Qi Fan
- Eye & ENT Hospital of Fudan University, Shanghai, China
| | | | | | | | | |
Collapse
|
38
|
Delayed-onset interface fluid syndrome after laser in situ keratomileusis secondary to combined cataract and vitreoretinal surgery. J Cataract Refract Surg 2012; 38:548-50. [DOI: 10.1016/j.jcrs.2011.12.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 09/28/2011] [Accepted: 09/28/2011] [Indexed: 11/19/2022]
|
39
|
Persistent Lamellar Interface Fluid With Clear Cornea After Descemet Stripping Automated Endothelial Keratoplasty. Cornea 2011; 30:1485-7. [DOI: 10.1097/ico.0b013e3182068974] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
40
|
Bolívar G, Teus M, Arranz-Marquez E. Effect of acute increases of intraocular pressure on corneal pachymetry in eyes treated with travoprost: an animal study. Curr Eye Res 2011; 36:1014-9. [PMID: 21942300 DOI: 10.3109/02713683.2011.608239] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To evaluate "in vivo" the effect of topical travoprost on the central corneal thickness (CCT) of rabbit eyes, and the changes in the CCT after acute increases of intraocular pressure (IOP) in these eyes. MATERIALS AND METHODS This is an interventional, prospective, case-control, masked study. Topical travoprost was applied once daily for one month to the right eye of six New Zealand male rabbits, the left eye of each animal served as control. The baseline CCT and IOP were measured under general anesthesia. After the IOP was stabilized at 15 and 30 mmHg, as registered by direct cannulation of the anterior chamber, CCT measurements were measured again at both pressure levels. RESULTS The baseline CCT was thicker in eyes previously treated with travoprost (study group) than in control eyes (p < 0.01). The CCT decreased in both groups when IOP was raised to 15 and 30 mmHg, and there were no statistically significant difference in absolute CCT values between study and control eyes at any of the IOP levels (p = 0.5). However, the amount of CCT decrease from baseline values was greater in eyes previously treated with travoprost (study group) than in control ones, at both 15 and 30 mmHg IOP levels (p = 0.01 and 0.02, respectively). CONCLUSIONS Rabbit corneas treated with topical travoprost show a different strain response to acute increases in IOP than control eyes.
Collapse
Affiliation(s)
- Gema Bolívar
- Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.
| | | | | |
Collapse
|
41
|
Woodward MA, Edelhauser HF. Corneal endothelium after refractive surgery. J Cataract Refract Surg 2011; 37:767-77. [PMID: 21420604 DOI: 10.1016/j.jcrs.2011.01.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Revised: 10/28/2010] [Accepted: 10/29/2010] [Indexed: 11/25/2022]
Abstract
UNLABELLED The endothelium is vital to the health and optical clarity of the human cornea. The safety of procedures to correct refractive errors depends on preservation of an intact corneal endothelium. Disease states and genetic and environmental factors affect the corneal endothelium; an unstable corneal endothelium can impact the success of refractive surgery. Technological advances and recent laboratory findings have improved the ability to assess the endothelium. The status of the corneal endothelium after laser in situ keratomileusis, photorefractive keratectomy, phakic intraocular lenses, and adjuvants to these treatments has been the topic of numerous clinical trials. Safety guidelines for refractive surgery procedures should be followed to minimize deleterious effects on the corneal endothelium. FINANCIAL DISCLOSURE Neither author has a financial or proprietary interest in any material or method mentioned.
Collapse
|
42
|
Elderkin SJ, Epstein RJ, Seldomridge DL. Successful Treatment of Recurrent Epithelial Ingrowth Associated with Interface Fluid Syndrome, Flap Necrosis, and Epithelial Defects Following LASIK. J Refract Surg 2011; 27:70-3. [DOI: 10.3928/1081597x-20100525-01] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Accepted: 04/27/2010] [Indexed: 11/20/2022]
|
43
|
|
44
|
Verrier I, Veillas C, Lépine T, Nguyen F, Thuret G, Gain P. Interfaces detection after corneal refractive surgery by low coherence optical interferometry. BIOMEDICAL OPTICS EXPRESS 2010; 1:1460-1471. [PMID: 21258562 PMCID: PMC3018127 DOI: 10.1364/boe.1.001460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Revised: 11/10/2010] [Accepted: 11/12/2010] [Indexed: 05/30/2023]
Abstract
The detection of refractive corneal surgery by LASIK, during the storage of corneas in Eye Banks will become a challenge when the numerous operated patients will arrive at the age of cornea donation. The subtle changes of corneal structure and refraction are highly suspected to negatively influence clinical results in recipients of such corneas. In order to detect LASIK cornea interfaces we developed a low coherence interferometry technique using a broadband continuum source. Real time signal recording, without moving any optical elements and without need of a Fourier Transform operation, combined with good measurement resolution is the main asset of this interferometer. The associated numerical processing is based on a method initially used in astronomy and offers an optimal correlation signal without the necessity to image the whole cornea that is time consuming. The detection of corneal interfaces - both outer and inner surface and the buried interface corresponding to the surgical wound - is then achieved directly by the innovative combination of interferometry and this original numerical process.
Collapse
Affiliation(s)
- I. Verrier
- Université de Lyon, F-42023, Saint-Etienne, France
- CNRS, UMR 5516, Laboratoire Hubert Curien, F-42000 Saint-Etienne, France
| | - C. Veillas
- Université de Lyon, F-42023, Saint-Etienne, France
- CNRS, UMR 5516, Laboratoire Hubert Curien, F-42000 Saint-Etienne, France
| | - T. Lépine
- Université de Lyon, F-42023, Saint-Etienne, France
- CNRS, UMR 5516, Laboratoire Hubert Curien, F-42000 Saint-Etienne, France
- Institut d’Optique Rhône-Alpes, 18, rue Benoît LAURAS 42000 Saint-Etienne, France
| | - F. Nguyen
- Université de Lyon, F-42023, Saint-Etienne, France
- Laboratoire Biologie, Ingénerie et Imagerie de la Greffe de Cornée, JE2521, IFR143,
Université Saint-Etienne, Jean Monnet, F-42000, Saint-Etienne, France
| | - G. Thuret
- Université de Lyon, F-42023, Saint-Etienne, France
- Laboratoire Biologie, Ingénerie et Imagerie de la Greffe de Cornée, JE2521, IFR143,
Université Saint-Etienne, Jean Monnet, F-42000, Saint-Etienne, France
| | - P. Gain
- Université de Lyon, F-42023, Saint-Etienne, France
- Laboratoire Biologie, Ingénerie et Imagerie de la Greffe de Cornée, JE2521, IFR143,
Université Saint-Etienne, Jean Monnet, F-42000, Saint-Etienne, France
| |
Collapse
|
45
|
Ursea R, Feng MT. Traumatic Flap Striae 6 Years After LASIK: Case Report and Literature Review. J Refract Surg 2010; 26:899-905. [DOI: 10.3928/1081597x-20091209-02] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Purpose:
To report a case of traumatic flap striae without flap dislocation 6 years after LASIK and provide a literature review of surgical flap striae, late traumatic flap striae, and their management.
Methods:
A 28-year-old man presented with late traumatic flap striae without concurrent flap dislocation, which closely approximated the longest reported interval between LASIK and the development of flap striae.
Results:
In the absence of flap dislocation, the finding of striae alone was subtle and went undetected initially. The flap was successfully refloated, stretched, and smoothed with recovery of 20/20 vision.
Conclusions:
Traumatic LASIK flap complications may occur many years after the original procedure. This report presents the first case of late traumatic flap striae without concurrent flap dislocation. Proper management can restore good visual function.
Collapse
|
46
|
Hafezi F, Seiler T. Persistent subepithelial haze in thin-flap LASIK. J Refract Surg 2010; 26:222-5. [PMID: 19810662 DOI: 10.3928/1081597x-20090930-02] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2009] [Accepted: 09/03/2009] [Indexed: 11/20/2022]
Abstract
PURPOSE To report persistent subepithelial haze in two patients following femtosecond LASIK associated with creation of a thin flap. METHODS Subepithelial haze was assessed by slit-lamp photography, high-resolution Scheimpflug imaging, and corneal confocal microscopy. RESULTS Two patients showed distinct subepithelial haze and reduced corrected distance visual acuity at 3 months after LASIK with a think-flap generated by a femtosecond laser. The extent of haze was documented, and the haze was treated topically with steroids up to 12 weeks. The haze was localized approximately 20 to 40 microm below Bowman's layer and dissolved slowly during the 2 months of treatment. At 6 months after surgery, uncorrected visual acuity was 20/20. CONCLUSIONS Subepithelial haze formation represents a new potential complication in the thin-flap LASIK.
Collapse
Affiliation(s)
- Farhad Hafezi
- Institute for Refractive and Opthalmic Surgery, Zurich, Switzerland.
| | | |
Collapse
|
47
|
Waring GO. Appropriate term for post-LASIK corneal edema. J Cataract Refract Surg 2009; 35:1482-3; author reply 1483. [PMID: 19631151 DOI: 10.1016/j.jcrs.2009.03.046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2009] [Accepted: 03/26/2009] [Indexed: 10/20/2022]
|
48
|
Affiliation(s)
- Sunil Kumar
- Department of Ophthalmology, Mohammad Dossary Hospital, Al Khobar, Saudi Arabia.
| |
Collapse
|
49
|
Grossniklaus HE. Lessons from the pathology laboratory: hints to improve outcomes. Ophthalmology 2009; 116:601-2. [PMID: 19344818 DOI: 10.1016/j.ophtha.2008.12.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2008] [Accepted: 12/08/2008] [Indexed: 11/27/2022] Open
|
50
|
Melki S, Todani A. LASIK interface fluid. Ophthalmology 2009; 116:815; author reply 816. [PMID: 19344832 DOI: 10.1016/j.ophtha.2008.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2008] [Accepted: 04/21/2008] [Indexed: 11/30/2022] Open
|