Kim Chung Young, Jung Young Ho, Lee Eun Ji, Hyon Joon Young, Park Kyu Hyung, Kim Tae Woo
Department of Ophthalmology, Seoul National University Hospital, Seoul, South Korea.
2nd Air Defense Missile Brigade, Republic of Korea Air Force, Gapyeong, South Korea.
BMC Ophthalmol. 2019 Mar 12;19(1):74. doi: 10.1186/s12886-019-1077-2.
Interface fluid syndrome (IFS) is an unusual complication after laser-assisted in-situ keratomileusis (LASIK). We report the first case of IFS after uncomplicated phacotrabeculectomy in a patient who had undergone LASIK 10 years previously. This case emphasizes the importance of intraocular pressure (IOP) interpretation in eyes that have undergone LASIK.
A 30-year-old woman with a history of LASIK surgery presented to glaucoma clinic due to uncontrolled IOP despite of maximally tolerable medical treatment. After receiving phacotrabeculectomy, IOP decreased to 3 mmHg on the first postoperative day, but again increased up to 21 mmHg and a diffuse corneal edema with cloudy flap interface was demonstrated by slit-lamp microscopy. Corneal edema was sustained even after the IOP was lowered to 14 mmHg. Spectral-domain optical coherence tomography scanning of the cornea revealed a diffuse, thin fluid pocket in the corneal interface. After laser lysis of the scleral flap sutures, IOP was further decreased to 9 mmHg and interface fluid was resolved.
IFS should be considered as a possible cause of postoperative corneal edema despite of low IOP in the eyes that underwent LASIK surgery. Additional IOP lowering may be helpful for resolving the corneal edema.
界面液体积聚综合征（IFS）是准分子激光原位角膜磨镶术（LASIK）后一种罕见的并发症。我们报告了首例在10年前接受过LASIK手术的患者，在进行无并发症的白内障小梁切除术后发生IFS的病例。该病例强调了在接受过LASIK手术的眼中解读眼压（IOP）的重要性。
一名有LASIK手术史的30岁女性因尽管接受了最大耐受量的药物治疗但眼压仍未得到控制而就诊于青光眼门诊。接受白内障小梁切除术后，术后第一天眼压降至3 mmHg，但随后又升至21 mmHg，裂隙灯显微镜检查显示弥漫性角膜水肿伴瓣界面混浊。即使眼压降至14 mmHg，角膜水肿仍持续存在。角膜的光谱域光学相干断层扫描显示角膜界面有弥漫性、薄的液性腔隙。在对巩膜瓣缝线进行激光松解后，眼压进一步降至9 mmHg，界面液体积聚消失。
在接受过LASIK手术的眼中，尽管眼压较低，IFS仍应被视为术后角膜水肿的可能原因。进一步降低眼压可能有助于解决角膜水肿。
