Epithelial ingrowth after LASIK treatment with scraping and phototherapeutic keratectomy.
OBJECTIVE
To evaluate the effect of phototherapeutic keratectomy (PTK) in combination with manual scraping when removing epithelial ingrowth under a LASIK flap.


METHODS
Three patients, who had undergone several surgeries following LASIK in order to remove epithelial ingrowth that was threatening vision, were treated with a flap lift, manual abrasion and PTK. The PTK was performed on both the stromal and the flap side with the aim of eliminating the threat and improving vision. Two patients underwent primary surgery to remove epithelial ingrowth with manual abrasion and PTK. The influence on vision, topography and cell recurrences was evaluated.


RESULTS
Uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA) improved in four cases and remained good in the fifth case. The refraction did not change significantly. Topography disclosed changes in the irregular astigmatism, explaining the improved BSCVA. Central epithelial ingrowth did not recur, whereas peripheral ingrowth did. The peripheral ingrowth did not progress, except in case 1, where a cyst formed that required surgery.


CONCLUSIONS
It is our belief that adding PTK to manual scraping improves the prognosis for eyes with epithelial ingrowth. It is mainly the central ingrowth that is positively affected. Improved adhesion between the stroma and the flap is one possible explanation.
Fagerholm
Per
P
Department of Ophthalmology, University Hospital, Linköping, Sweden. perfa@inr.liu.se
Molander
Nils
N
Podskochy
Alexander
A
Sundelin
Staffan
S
D000328:Adult; D001251:Astigmatism / Q000517:prevention & control; D003316:Corneal Diseases / Q000209:etiology / Q000601:surgery*; D019781:Corneal Topography; D003646:Debridement / Q000379:methods*; D004847:Epithelial Cells / Q000473:pathology; D019573:Epithelium, Corneal / Q000473:pathology*; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D018903:Photorefractive Keratectomy / Q000379:methods*; D011183:Postoperative Complications; D013524:Surgical Flaps / Q000473:pathology*; D014792:Visual Acuity