Treatment of epithelial ingrowth after laser in situ keratomileusis with mechanical debridement and flap suturing.
OBJECTIVE
To evaluate the efficacy and safety of mechanical debridement and suturing of the laser in situ keratomileusis (LASIK) flap in the treatment of clinically significant epithelial ingrowth after LASIK.


METHODS
In a retrospective study, 20 eyes (n = 19 patients) in which clinically significant epithelial ingrowth developed after LASIK were treated with lifting of the flap, scraping of the epithelial ingrowth, and flap suturing. Primary outcome measurements including recurrence of ingrowth, uncorrected visual acuity (VA), manifest refraction, best spectacle-corrected VA, and complications were evaluated at the last postoperative examination.


RESULTS
At the last postoperative examination (mean +/- SD, 10.5 +/- 14.3 months; range, 1.5-64 months), 100% of eyes had no recurrence of clinically significant epithelial ingrowth. The uncorrected VA changed from 20/20 or better in 7 eyes (35%) and 20/40 or better in 15 eyes (75%) preoperatively to 20/20 or better in 9 eyes (45%) and 20/40 or better in 16 eyes (80%) at the last follow-up examination. There was no significant change in the mean logarithm of the minimum angle of resolution (logMAR) uncorrected VA before (mean +/- SD, 0.3 +/- 0.5; range, -0.1 to 1.7) and after surgery (mean +/- SD, 0.2 +/- 0.4; range, -0.1 to 1.7) (P =.40). Mean +/- SD spherical equivalent changed from -0.21 +/- 0.82 diopters (D) (range, -1.25 to 1.00 D) preoperatively to -0.53 +/- 0.89 D (range, -2.50 to 0.38 D) at last follow-up (P =.30). No eyes lost 2 or more lines of best spectacle-corrected VA, and there were no complications associated with the treatment.


CONCLUSIONS
Suturing the LASIK flap in addition to mechanical debridement of epithelial ingrowth is a safe and effective treatment for clinically significant epithelial ingrowth after LASIK.
Rojas
Maria C
MC
Department of Ophthalmology, Stanford University School of Medicine, Stanford, Calif. 94305, USA.
Lumba
Joanna D
JD
Manche
Edward E
EE
D000328:Adult; D003131:Combined Modality Therapy; D003316:Corneal Diseases / Q000209:etiology / Q000601:surgery*; D003646:Debridement / Q000379:methods*; D019573:Epithelium, Corneal / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence; D012029:Refraction, Ocular; D012189:Retrospective Studies; D012449:Safety; D013524:Surgical Flaps; D013536:Suture Techniques; D016896:Treatment Outcome; D014792:Visual Acuity