Purpose: To report ocular manifestations of eyes that developed interface fluid syndrome secondary to steroid-induced elevation of intraocular pressure (IOP) after LASIK. The patients presented with similiar characteristics of diffuse lamellar keratitis (DLK).
Methods: Retrospective evaluation of four eyes of three patients with loss of vision, fluid in the lamellar interface, and IOP and topographic changes due to prolonged treatment with topical corticosteroids after LASIK.
Results: Slit-lamp microscopy revealed an optically clear fluid-filled space between the flap and stromal bed. After early diagnosis, treatment with topical corticosteroids was stopped, resulting in quick and progressive cessation of symptoms.
Conclusions: A steroid-induced rise in IOP after LASIK can cause transudation of aqueous fluid across the endothelium that collects in the flap interface. It is important to make an early differential diagnosis of interface fluid syndrome in DLK-suspected cases, as continued treatment with corticosteroids can produce serious visual loss.