Fibrin adhesive in conjunction with epithelial ingrowth removal after laser in situ keratomileusis: long-term results.
OBJECTIVE
To describe the long-term results of fibrin adhesive use in the management of epithelial ingrowth after laser in situ keratomileusis (LASIK).


METHODS
Private practice, Minneapolis, Minnesota, and an academic medical center, Durham, North Carolina, USA.


METHODS
Retrospective case series.


METHODS
Patients with a history of LASIK had epithelial ingrowth removal with mechanical debridement and fibrin glue application. Visual outcomes and the presence or absence of epithelial ingrowth were evaluated again after 3 months and at the last follow-up. The main outcome measures were recurrence of epithelial ingrowth and visual acuity.


RESULTS
Thirty-nine eyes of 38 patients were evaluated. After epithelial ingrowth removal and application of fibrin glue, 31 eyes (79.5%) had no recurrence of ingrowth at the final follow-up and 5 eyes (12.8%) had mild epithelial ingrowth not requiring removal. Three eyes (7.7%) had significant epithelial ingrowth at the 3-month follow-up that required subsequent removal and fibrin application. At the 3-month follow-up visit, 76.9% of eyes achieved 20/25 or better corrected distance visual acuity (CDVA) and 69.2% of eyes achieved 20/40 or better uncorrected distance visual acuity (UDVA). At the last follow-up visit (mean 26.6 ± 17.0 months [SD]), 84.6% of eyes had 20/25 or better CDVA and 74.4% of eyes had 20/40 or better UDVA.


CONCLUSIONS
Fibrin adhesive in conjunction with manual epithelial removal prevented a clinically significant recurrence of epithelial ingrowth in the majority of eyes. Larger randomized studies are needed to compare the success of this technique with that of others.


BACKGROUND
No author has a financial or proprietary interest in any material or method mentioned.
From the Minnesota Eye Consultants (Hardten, Fahmy, Berdahl), Minneapolis, Minnesota, and Duke University Eye Center (Vora, Kim), Durham, North Carolina, USA.
David R
DR
Hardten
From the Minnesota Eye Consultants (Hardten, Fahmy, Berdahl), Minneapolis, Minnesota, and Duke University Eye Center (Vora, Kim), Durham, North Carolina, USA.
Mona M
MM
Fahmy
From the Minnesota Eye Consultants (Hardten, Fahmy, Berdahl), Minneapolis, Minnesota, and Duke University Eye Center (Vora, Kim), Durham, North Carolina, USA.
Gargi K
GK
Vora
From the Minnesota Eye Consultants (Hardten, Fahmy, Berdahl), Minneapolis, Minnesota, and Duke University Eye Center (Vora, Kim), Durham, North Carolina, USA.
John P
JP
Berdahl
From the Minnesota Eye Consultants (Hardten, Fahmy, Berdahl), Minneapolis, Minnesota, and Duke University Eye Center (Vora, Kim), Durham, North Carolina, USA. Electronic address: terry.kim@duke.edu.
Terry
T
Kim
D000328:Adult; D003316:Corneal Diseases / Q000503:physiopathology / Q000517:prevention & control*; D003646:Debridement; D019573:Epithelium, Corneal / Q000473:pathology*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D012008:Recurrence; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D013524:Surgical Flaps; D014014:Tissue Adhesives / Q000627:therapeutic use*; D014792:Visual Acuity / Q000502:physiology
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives