Interface Fluid Syndrome Immediate Recovery After 30-Gauge Needle Paracentesis

Interface fluid syndrome (IFS) is a rare complication of Laser in situ keratomileusis (LASIK), in which rapid diagnosis and management is crucial to avoid potential severe complications. We report the case of an IFS where the interface fluid disappeared immediately after single 30-gauge needle paracentesis.

University of Parma

A 56-year-old asked for refractive surgery in his left eye (LE). He reported an old blunt trauma that had led to cataract surgery many years before. The endothelial cell count was 1241 cells/mm². After receiving LASIK, he developed IFS which was detected one week later, with intraocular pressure (IOP), as measured with a rebound tonometer, of 14 mmHg at the centre of the cornea and 31 mmHg at the peripheral cornea. We immediately performed corneal 30-gauge needle paracentesis, which allowed to lower the IOP. Our patient reported rapid subjective vision improvement within the first 30 minutes and almost complete fluid absorption from the flap interface was noticed after 3 hours. A single topical hypotensive drug was then prescribed to avoid any further IOP rise. Three weeks after the procedure the visual acuity was almost fully restored with mild residual refractive error.

Ocular paracentesis was effective in treating the IFS in this case. It can be considered to achieve rapid IOP lowering in IFS, followed by topical hypotensive drugs to maintain the result. The rebound tonometer proved to be very effective in obtaining peripheral IOP measurement in this case.