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Delayed-Onset Interface Fluid Syndrome After Laser-Assisted In Situ Keratomileusis Secondary to Descemet Stripping Automated Endothelial Keratoplasty

Alberto Villarrubia, MD1; Antonio Cano-Ortiz, MD1
[+] Author Affiliations
1Instituto de Oftalmología La Arruzafa de Córdoba, Córdoba, Spain
JAMA Ophthalmol. 2014;132(8):1028-1029. doi:10.1001/jamaophthalmol.2014.960.
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Descemet stripping automated endothelial keratoplasty (DSAEK) has become the preferred surgical treatment for patients with endothelial dysfunction.1 Interface fluid syndrome (IFS) is an uncommon complication after laser-assisted in situ keratomileusis (LASIK) in which diffuse pockets of fluid collect within the interface. Typical cases of IFS are associated with steroid-induced intraoperative pressure (IOP) increase after LASIK.2,3 We describe a patient who had undergone anterior chamber phakic intraocular lens (IOL) implantation and LASIK for high myopia. Five years later, she required DSAEK owing to endothelial dysfunction. She presented with IFS in the immediate postoperative period.

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Figure 1.
Interface Fluid Syndrome After Descemet Stripping Automated Endothelial Keratoplasty in a Patient Who Has Undergone Laser-Assisted In Situ Keratomileusis

Anterior segment optical coherence tomographic image (Visante; Zeiss) 10 days after Descemet stripping automated endothelial keratoplasty. A space without a signal between the laser-assisted in situ keratomileusis flap and the anterior stroma of the recipient cornea is clearly seen. The donor disc is well attached. Red bars indicate the thickness of the disc used in Descemet stripping automated endothelial keratoplasty.

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Figure 2.
Complete Resolution of Interface Fluid Syndrome After Hypotensive Treatment

Anterior segment optical coherence tomographic image (Visante; Zeiss) 24 days after Descemet stripping automated endothelial keratoplasty. Complete resolution of fluid accumulation in the laser-assisted in situ keratomileusis interface is shown (after the patient received hypotensive agents for 14 days).

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