Treatment Of Interface Fluid Syndrome After Lasik With Dmek In Patients With Corneal Endothelial Dysfunction

To review the clinical outcomes of DMEK in patients with interface fluid syndrome (IFS), a complication of LASIK in which endothelial failure can play a major role. DMEK has become a first-line treatment in corneal endothelial diseases owing to its exceptional clinical outcomes and low complication rates. Thanks to its refractive predictability and the ability to reshape the superficial cornea, DMEK is now also considered for managing cases with endothelial decompensation following previous refractive procedures.

Fundación de Oftalmologia Médica de la Comunidad Valenciana (FOM), Valencia, Spain

DMEK was proposed to restore corneal endothelial dysfunction and secondarily solve the IFS, both objetives succesfully achieved in the postoperative period in the three cases, although in one patient it was necessary to perform a new DMEK. During DMEK surgery in a patient who has undergone previous LASIK, corneal incisions should be performed outside the flap area to avoid flap dislocations, excesive tensive lines during descemetorrhexis are forbidden and graft manipulation from the outer corneal surface should be reduced. After surgery, the interface cleft may seem to have initially increased due to the inmediate functionality of endothelial cells.

DMEK is a safe and effective surgery to reverse IFS after LASIK in an eye with endothelial dysfunction. Due to the increasing incidence of this vision-impairing eye disease, it is worth keeping the IFS in mind when grading LASIK surgical risk. Certain details during surgery must be taken into account in these patients in order to avoid LASIK-flap dislocation.