Interface Fluid Syndrome After Bioptics Surgery

PURPOSE: To present a case of interface fluid syndrome (IFS) in a patient who underwent laser in situ keratomileusis (LASIK) followed by Implantable Collamer Lens (ICL) implantation. METHODS: Case report. RESULTS: A patient who had undergone astigmatic LASIK followed by ICL implantation elsewhere and was taking a postoperative regimen of topical steroid and lubricants was referred at 4 months postoperatively with uncorrected distance visual acuity (UDVA) of 20/400 in the left eye. The pupil was sluggish, there was severe corneal edema, and intraocular pressure (IOP) was 5 mm Hg with Goldmann applanation tonometry. Anterior segment optical coherence tomography indicated IFS. IFS was diagnosed and steroid-induced ocular hypertension was suspected. IFS likely resulted in the low central IOP readings but the peripheral IOP was 41 mm Hg. Topical steroids were halted and topical tafluprost every night and acetazolamide 250 mg four times a day were prescribed. By day 6 after presentation, the cornea was clear with complete resolution of IFS, UDVA was 20/25, and central and peripheral IOP was 14 mm Hg. CONCLUSIONS: IFS should be considered in patients who have had bioptics surgery and present with low to normal IOP, corneal edema, and decreased vision. [ Journal of Refractive Surgery Case Reports. 2022;2(1):e10–e13.]