Epithelial ingrowth in a corneal graft treated by laser in situ keratomileusis: light and electron microscopy.
OBJECTIVE
To demonstrate progressive epithelial ingrowth histopathologically in a human cornea after laser in situ keratomileusis (LASIK) and review its pathophysiology.


METHODS
Department of Ophthalmology, Medical College of Virginia Campus, Virginia Commonwealth University, and the Veterans Affairs Medical Center, Richmond, Virginia, USA.


METHODS
Tissue from a corneal transplant specimen was examined 6 weeks after LASIK by light and transmission electron microscopy.


RESULTS
Epithelial ingrowth in the flap interface with connection to the surface corneal epithelium was evident on light microscopy. In areas without epithelial ingrowth, the flap interface was imperceptible. Electron microscopy revealed minimal disruption of the stromal collagenous lamellae.


CONCLUSIONS
Progressive epithelial ingrowth occurred with a continuous sheet of epithelium to the flap edge. Location of epithelial ingrowth and cytokine epithelial-stromal interaction appear to be important factors in this complication. Histopathological changes in the cornea after LASIK are difficult to detect in areas with normal wound healing.
Wright
J D
JD
Medical College of Virginia, Richmond, USA.
Neubaur
C C
CC
Stevens
G
G
D000328:Adult; D016039:Corneal Transplantation / Q000473:pathology*; D019573:Epithelium, Corneal / Q000473:pathology* / Q000648:ultrastructure; D006801:Humans; D007640:Keratoconus / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008297:Male; D011183:Postoperative Complications / Q000473:pathology*; D012086:Reoperation; D012189:Retrospective Studies; D013524:Surgical Flaps; D014945:Wound Healing