Management Of Interface Fluid Syndrome After Lasik In A Patient With Fuchs Endothelial Dystrophy Reversed By Descemet Membrane Endothelial Keratoplasty

Case report of a case of interface fluid syndrome after laser in situ keratomileusis (LASIK) with Fuchs endothelial dystrophy reversed by Descemet membrane endothelial keratoplasty (DMEK).

53-year-old male who underwent LASIK procedure 20 years prior developed left eye visual impairment owing to interface fluid syndrome secondary to Fuchs endothelial dystrophy. DMEK was performed in the left eye.

The patient presented with central confluent guttae and corneal thickening in both eyes. Additional fluid at the interface where LASIK was performed was observed in the left eye. The right eye presented no additional abnormalities. Best corrected visual acuity was 0.5 on the right eye and 0.4 on the left eye. The patient underwent uneventful DMEK on the left eye. 24h after surgery the graft appeared well positioned. The corneal edema greatly improved at the follow-up 15 days post-surgery, presenting with minimal fluid at the interface with a consequential improvement in visual acuity 1 month after surgery.

Interface fluid syndrome is an interface-related complication of LASIK which can be triggered by endothelial cell dysfunction secondary to dystrophic endothelial cell loss. This case contributes to evidence that DMEK is capable to reverse visual impairment caused by interface fluid syndrome after LASIK with concomitant endothelial dysfunction allowing fast visual recovery.