Document Detail


Interface fluid and diffuse corneal edema after laser in situ keratomileusis.
MedLine Citation:
PMID:  11316019     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To report a new complication of interface fluid accumulation and corneal edema in an uneventful laser in situ keratomileusis (LASIK) procedure. METHODS: Uncomplicated bilateral LASIK for myopia using the Hansatome microkeratome was performed. One day postoperatively, the patient noted decreased visual acuity. The topical corticosteroid was changed from dexamethasone to prednisolone acetate 1% every 2 hours. Two weeks later the patient reported worsening visual acuity in both eyes. Uncorrected visual acuity was 20/200 in the right eye and 20/100 in the left. Slit-lamp biomicroscopy indicated significant fluid build-up in the interface. Intraocular pressure (IOP) by Goldmann applanation tonometry was 15 mmHg in the right eye and 14 mmHg in the left. RESULTS: After 4 weeks, intraocular pressure by bidigital pressure was increased and high. The corticosteroid was discontinued and antiglaucoma medication lowered the intraocular pressure, which resulted in corneal clearing and disappearence of interface fluid in both eyes. CONCLUSIONS: Early recognition of this new complication of LASIK is necessary. The falsely low reading of IOP in the setting of interface fluid was the result of easy compressibility of the fluid-filled space and reflects the pressure of the interface fluid. This apparently low IOP reading can be an additional sign of the existence of interface fluid. The corticosteroid should be discontinued and antiglaucoma medication instituted. This should lead to a lowering of intraocular pressure and result in corneal clearing and disappearence of the interface fluid with improvement in visual acuity.
Authors:
W Portellinha; M Kuchenbuk; K Nakano; M Oliveira
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of refractive surgery (Thorofare, N.J. : 1995)     Volume:  17     ISSN:  1081-597X     ISO Abbreviation:  J Refract Surg     Publication Date:    2001 Mar-Apr
Date Detail:
Created Date:  2001-04-23     Completed Date:  2001-07-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9505927     Medline TA:  J Refract Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S192-5     Citation Subset:  IM    
Affiliation:
Excimer Laser Santa Cruz, São Paulo, Brazil.
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MeSH Terms
Descriptor/Qualifier:
Adult
Astigmatism / surgery
Body Fluids / metabolism*
Corneal Edema / etiology*,  metabolism
Female
Humans
Intraocular Pressure
Keratomileusis, Laser In Situ / adverse effects*
Myopia / surgery*
Tonometry, Ocular
Visual Acuity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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