J Korean Ophthalmol Soc.  2011 Dec;52(12):1434-1439. 10.3341/jkos.2011.52.12.1434.

The Analysis of Epithelial Ingrowth after LASIK Using a Femtosecond Laser

• Jung HJ
• Kim SW
• Lee TH
• Lee KH

• KMID: 2215146
• DOI: http://doi.org/10.3341/jkos.2011.52.12.1434

Abstract

PURPOSE
To analyze the incidence and clinical course of epithelial ingrowth after laser in situ keratomileusis (LASIK) using a femtosecond laser.
METHODS
We retrospectively evaluated the results of 1158 eyes of 581 patients who received LASIK with the flap created by a femtosecond laser from February 2006 to March 2009 at our institute. We investigated the incidence and clinical course of LASIK in which the flap was created by a femtosecond laser.
RESULTS
Epithelial ingrowth was first detected one week after surgery in 12 (57%) of 21 eyes and within one month in 19 eyes (90%). Epithelial ingrowth was localized most commonly near the temporal and nasal flap edge in 12 eyes (57%). In two eyes (9.5%), an isolated ingrowth mass was located in the pupillary area. The development of more than 2.0 mm of epithelial ingrowth was observed in three eyes (0.25%). Among 28 eyes with loose epithelium or epithelial detachment during surgery, epithelial ingrowth was observed in six eyes (21.4%) compared with 15 (1.32%) of 1130 eyes without loose epithelium or epithelial detachment. Therefore, epithelial detachment during surgery was significantly associated with epithelial ingrowth (p = 0.00).
CONCLUSIONS
In LASIK in which the flap is created by a femtosecond laser, damage to the epithelial layer increases the chances of epithelial ingrowth. Therefore, avoiding epithelial defects with a gentle maneuver is needed to reduce the chance of epithelial ingrowth during surgery.

Keyword

Epithelial ingrowth; Femtosecond laser; LASIK

MeSH Terms

Epithelium
Eye
Humans
Incidence
Keratomileusis, Laser In Situ
Retrospective Studies

Figure

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  Figure 1. Isolated ingrowth mass was located in the pupillary area.

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  Figure 2. Epithelial ingrowth was located in hinge area.

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  Figure 3. Epithelial ingrowth does not improve or aggravate. (A) 8 days after LASIK. (B) 22 days after LASIK.

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  Figure 4. BCVA & Post OP mean spherical equivalent.

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  Figure 5. Incidence of epithelial detachment in epithelial ingrowth group and in no ingrowth group. There was significant relationship between incidence of epithelial detachment and epithelial ingrowth (p=0.00).

Reference

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