Post-LASIK interface fluid syndrome caused by steroid drops

Area of Science:

• Ophthalmology
• Corneal Surgery
• Postoperative Complications

Background:

• Interface fluid syndrome (IFS) is a rare but serious complication following laser in situ keratomileusis (LASIK).
• Prolonged topical steroid use is a potential risk factor for developing IFS.
• IFS can present with signs that mimic other conditions like diffuse lamellar keratitis (DLK).

Purpose of the Study:

• To describe a case series of patients who developed interface fluid syndrome (IFS) after LASIK.
• To investigate the role of prolonged steroid use in the development of IFS.
• To report the outcomes of managing IFS by discontinuing steroids and initiating anti-glaucoma therapy.

Main Methods:

• Retrospective case series of 8 eyes that developed IFS post-LASIK.
• Clinical presentation, slit-lamp examination findings, and intraocular pressure (IOP) were documented.
• Treatment involved cessation of topical steroids and initiation of anti-glaucoma medications.

Main Results:

• All 8 patients developed IFS after prolonged steroid use for presumed diffuse lamellar keratitis (DLK).
• Clinical signs included corneal haze and a fluid-filled space between the flap and stroma.
• High intraocular pressure (IOP) was observed in all affected eyes.
• Discontinuation of steroids and glaucoma treatment led to significant visual improvement.

Conclusions:

• Prolonged steroid use can precipitate interface fluid syndrome (IFS) in post-LASIK eyes.
• IFS should be considered in patients presenting with worsening corneal haze and elevated IOP after LASIK, especially with steroid exposure.
• Management involves steroid withdrawal and appropriate IOP control, leading to favorable visual outcomes.