Complications & Risks Of LASIK - Epithelial Ingrowth

The surface layer of the cornea is the epithelium. If damaged, epithelial cells regenerate. Epithelial ingrowth is the term for cells growing under the LASIK flap. It is a relatively common complication of LASIK. The incidence has been reported to be as low as 0.2% and as high as 15% and it is essentially the same regardless whether the corneal flap was created with a Microkeratome or a Femtosecond Laser.

Complications & Risks Of LASIK - Epithelial Ingrowth

Epithelial Ingrowth after LASIK appears as whitish islands in the cornea when illuminated. It may be mild, which is usually asymptomatic and seen on routine evaluation. In moderate cases, the patient may have foreign body sensation, photophobia, congestion, pain, irritation, ghosting, glare and halos as well as loss of best corrected visual acuity. In severe cases, It can cause haze and discomfort, especially if the lifted edge is sensed when blinking.

Reasons

The risk factors for its development include epithelial defects at the time of or soon after surgery, epithelial basement membrane dystrophy, hyperopic LASIK corrections, repeated LASIK surgery, flap instability, presence of diffuse lamellar keratitis (DLK), and a history of epithelial ingrowth in the fellow eye.

Treatment

  • Most cases of epithelial ingrowth are self-limiting, don't cause discomfort or vision problems. The limited, benign form of epithelial ingrowth, 2 mm in diameter or less, does not require treatment.

  • Treatment is required only when epithelial ingrowth interferes with visual acuity or irregular astigmatism. The most common resolution for epithelial ingrowth is for the doctor to lift the flap, wash out the area, and reposition the flap. In some cases, the doctor will apply a small amount of excimer energy or a diluted alcohol solution to destroy any remaining cells.