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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.
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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
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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.
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Asif MI, Bafna RK, Mehta JS, Reddy J, Titiyal JS, Maharana PK, Sharma N. Complications of small incision lenticule extraction. Indian J Ophthalmol 2020; 68:2711-2722. [PMID: 33229647 PMCID: PMC7856979 DOI: 10.4103/ijo.ijo_3258_20] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The procedure of small incision lenticule extraction (SMILE) was introduced in 2011, and since then there has been an increase in the number of cases undergoing this procedure worldwide. The surgery has a learning curve and may be associated with problems in the intraoperative and postoperative periods. The intraoperative problems during SMILE surgery include the loss of suction, the occurrence of altered or irregular opaque bubble layer and black spots, difficulty in lenticular dissection and extraction, cap perforation, incision-related problems, and decentered ablation. Most of the postoperative problems are similar as in other laser refractive procedures, but with decreased incidence. The identification of risk factors, clinical features, and management of complications of SMILE help to obtain optimum refractive outcomes.
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Affiliation(s)
- Mohamed Ibrahime Asif
- Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Rahul Kumar Bafna
- Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Jodhbir Singh Mehta
- Singapore Eye Research Institute; Singapore National Eye Centre, 168751; Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore
| | - Jagadesh Reddy
- Cataract and Refractive Services, Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Jeewan Singh Titiyal
- Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Prafulla K Maharana
- Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Namrata Sharma
- Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Trinh L, Baudouin C, Bouheraoua N. [Interface fluid syndrome after SMILE surgery]. J Fr Ophtalmol 2020; 44:e15-e17. [PMID: 33172714 DOI: 10.1016/j.jfo.2020.04.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 10/23/2022]
Affiliation(s)
- L Trinh
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, IHU de Foresight, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France.
| | - C Baudouin
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, IHU de Foresight, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France; Service d'ophtalmologie, hôpital Ambroise-Paré, AP-HP, université de Versailles Saint-Quentin-en-Yvelines, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France
| | - N Bouheraoua
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, IHU de Foresight, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France; Inserm, Sorbonne université, CNRS, institut de la Vision, 17, rue Moreau, 75012 Paris, France
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Langer J, Priglinger S, Messmer EM, Dirisamer M, Shajari M, Mayer WJ. Penetrating keratoplasty after complicated small incision lenticule extraction a case report. Am J Ophthalmol Case Rep 2020; 19:100730. [PMID: 32637727 PMCID: PMC7327821 DOI: 10.1016/j.ajoc.2020.100730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 03/17/2020] [Accepted: 04/27/2020] [Indexed: 10/28/2022] Open
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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.
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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.
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