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Epithelial Ingrowth After LASIK: Visual and Refractive Results After Cleaning the Interface and Suturing the Lenticule

Güell, Jose L. MD, PhD*; Verdaguer, Paula MD; Mateu-Figueras, Gloria PhD; Elies, Daniel MD§; Gris, Oscar MD, PhD§; Manero, Felicidad MD§; Morral, Merce MD, PhD

doi: 10.1097/ICO.0000000000000214
Clinical Science

Purpose: The aim was to study the visual and refractive results in patients with epithelization in the corneal interface after laser in situ keratomileusis (LASIK) who were treated by cleaning the corneal interface (epithelial cyst extraction) and suturing the corneal flap.

Methods: This is a retrospective, noncomparative interventional case series. The main outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refractive cylinder (CYL), spherical equivalent (SE), recurrence of epithelial ingrowth, and complications.

Results: From a total of 7520 LASIK refractive eyes, 13 eyes with epithelial ingrowth were treated. The mean age was 46.9 years. The mean preoperative logMAR UDVA was 0.34 (SD, 0.19). At 2 months, the mean postoperative logMAR UDVA was 0.18 (SD, 0.17) and at 1 year was 0.12 (SD, 0.18) (P = 0.01). The mean logMAR CDVA before surgery was 0.16 (SD, 0.16). Two months and 1 year postoperatively, the mean logMAR CDVA was 0.05 (SD, 0.08) and 0.03 (SD, 0.06), respectively (P = 0.03). The mean SE before surgery was 0.30 D (SD, 1.09). The mean SE 2 months and 1 year after surgery was −0.07 (SD, 0.53) and −0.004 (SD, 0.18), respectively (P = 0.04). The mean CYL before surgery was −0.92 D (SD, 1.09); and the mean CYL 2 months and 1 year after surgery was −0.60 (SD, 0.84) and −0.18 (SD, 0.75), respectively (P = 0.26). No epithelial ingrowth recurrence was observed up to 1 year after epithelial removal.

Conclusions: Cleaning the corneal interface and suturing the corneal flap was effective and appeared safe in treating epithelial ingrowth after LASIK, with an extremely low rate of regrowth. However, further prospective controlled studies with a longer follow-up are needed.

*Director of Cornea and Refractive Surgery Unit, Instituto Microcirugía Ocular, Barcelona, Spain, and Universitat Autònoma de Barcelona, Barcelona, Spain;

Cornea and Refractive Surgery Unit, Instituto Microcirugía Ocular, Barcelona, Spain;

Universitat Autònoma de Barcelona, Barcelona, Spain;

§Department of Mathematics at Universitat de Girona, Girona, Spain; Cornea and Refractive Surgery Unit, Instituto Microcirugía Ocular, Barcelona, Spain; and

Instituto de Microcirugía Ocular, Barcelona, Spain, and Department of Cornea and Anterior Segment Diseases and Department of Refractive Surgery of the Institut Clinic d'Oftalmologia, Hospital Clinic i Provincial, Barcelona, Spain.

Reprints: Paula Verdaguer, MD, C/ Josep Maria Lladó no. 3, 08035 Barcelona, Spain (e-mail: paulaverdaguer@gmail.com).

The authors have no funding or conflicts of interest to disclose.

Received December 31, 2013

Received in revised form June 11, 2014

Accepted June 22, 2014

© 2014 by Lippincott Williams & Wilkins.