Mansoori Tarannum
Department of Glaucoma, Anand Eye Institute, Hyderabad, Telangana, India.
Oman J Ophthalmol. 2023 Mar 27;16(2):329-332. doi: 10.4103/ojo.ojo_112_22. eCollection 2023 May-Aug.
A 32-year-old male with a past history of bilateral laser-assisted keratomileusis (LASIK), presented with a decrease in vision in both eyes (BE). Clinical examination showed diffuse corneal haze and interface fluid syndrome (IFS), which was confirmed on anterior segment optical coherence tomography. Intraocular pressure (IOP) measurements obtained with Goldmann applanation tonometer (GAT) were low; however, digital tonometry indicated a raised IOP in BE, which was confirmed by measuring IOP with GAT, outside the peripheral edge of the LASIK flap. Treatment with antiglaucoma medications resulted in complete resolution of the interface fluid. However, due to noncompliance with medications, it recurred and glaucoma showed progression. The patient underwent trabeculectomy with mitomycin C in BE, resulting in improvement in the visual acuity, clear cornea, resolution of interface fluid, and normal IOP, till the last follow-up visit. This case had IFS secondary to episodes of raised IOP, which was diagnosed on careful clinical examination. IOP readings using GAT over the central cornea can give spuriously low readings in IFS. Hence, IOP should be measured in the peripheral cornea to obtain correct IOP readings. Early detection of high IOP and its management is essential to halt glaucoma progression.
一名32岁男性，既往有双眼准分子激光原位角膜磨镶术（LASIK）史，双眼视力下降。临床检查发现弥漫性角膜混浊和界面液综合征（IFS），前段光学相干断层扫描证实了这一情况。用戈德曼压平眼压计（GAT）测量的眼压（IOP）较低；然而，指测眼压显示双眼IOP升高，在LASIK瓣周边缘外使用GAT测量IOP证实了这一点。使用抗青光眼药物治疗后界面液完全消退。然而，由于患者未遵医嘱用药，界面液复发且青光眼病情进展。患者双眼接受了丝裂霉素C小梁切除术，直至最后一次随访，视力提高、角膜清亮、界面液消退且IOP正常。该病例的IFS继发于IOP升高，经仔细临床检查确诊。在IFS中，使用GAT测量中央角膜的IOP读数可能会出现假性低值。因此，应在周边角膜测量IOP以获得正确的IOP读数。早期发现高眼压并进行处理对于阻止青光眼进展至关重要。
