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Post-Laser In Situ Keratomileusis Epithelial Ingrowth

Treatment, Recurrence, and Long-Term Results

Yesilirmak, Nilufer, MD*,†; Chhadva, Priyanka, MD*,‡; Cabot, Florence, MD*; Galor, Anat, MD, MSPH*,§; Yoo, Sonia H., MD*

doi: 10.1097/ICO.0000000000001760
Clinical Science

Purpose: To study outcomes after surgical removal of epithelial ingrowth (EI) in post-laser in situ keratomileusis patients, specifically comparing visual results and recurrence rates between 2 different EI management techniques.

Methods: In this retrospective chart review of 67 eyes of 54 patients who underwent surgical treatment for EI after laser in situ keratomileusis between July 1999 and July 2014 at the Bascom Palmer Eye Institute, Miami, FL, surgical techniques, recurrence rates, visual acuity (VA), and refractive error were assessed.

Results: Of the 67 eyes, 56 eyes (83.6%) had flap lift + scraping alone, and 11 eyes (16.4%) had flap lift + scraping + suturing. After mean follow-up of 2.5 years, 11 of 56 eyes (19.6%) treated with flap lift + scraping alone had EI recurrence, whereas no eyes treated with flap lift + scraping + suturing had EI recurrence. VA results and refractive errors were better in eyes treated with lift + scraping alone compared with lift + scraping + suturing at 1 month. In the 67 eyes with 1-year follow-up, VA and refractive errors improved from preoperative values and were comparable between groups.

Conclusions: Scraping alone provides significantly better initial visual outcomes but higher EI recurrence rates compared with scrape–suturing. Long-term visual outcomes are comparable between 2 techniques.

*Bascom Palmer Eye Institute, Cornea Department, University of Miami, Miami, FL;

Department of Ophthalmology, Yildirim Beyazit University, Ankara, Turkey;

Department of Ophthalmology, Illinois Eye and Ear Infirmary, University of Illinois, Chicago, IL; and

§Miami Veterans Administration Medical Center, Department of Ophthalmology, Miami, FL.

Correspondence: Sonia H. Yoo, MD, Bascom Palmer Eye Institute, University of Miami, 900 NW, 17th St, Miami, FL 33136 (e-mail:

A. Galor and S. H. Yoo have relevant financial activities outside the submitted work. The remaining authors have no funding or conflicts of interest to disclose.

Received June 11, 2018

Accepted August 04, 2018

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.