J Korean Ophthalmol Soc.  2011 Aug;52(8):984-989. 10.3341/jkos.2011.52.8.984.

Combined Mitomycin-C Assisted Photorefractive Keratectomy in the Treatment of Epithelial Ingrowth after LASIK

• Shin HY
• Cho KJ
• Kim MS

• KMID: 2214778
• DOI: http://doi.org/10.3341/jkos.2011.52.8.984

Abstract

PURPOSE
To report 2 cases of thick, late-onset and long-standing epithelial ingrowth after laser-assisted in situ keratomilusis (LASIK) using mitomycin C-assisted photorefractive keratectomy and flap suturing.
CASE SUMMARY
The first case involved a 29-year-old woman who had LASIK in both eyes in 2002. She was diagnosed with epithelial ingrowth OD after blunt ocular trauma in 2007. The second case involved a 30-year-old man who had LASIK in both eyes in 1999 followed by enhancements in 2004. Slit lamp examination showed dense epithelial ingrowth OS in a geographic pattern. Two eyes of the 2 patients with epithelial ingrowth had flap lifting followed by debridement of interface epithelial cells, photorefractive keratectomy, interface application of mitomycin C, and the placement of interrupted 10-0 nylon sutures. Two eyes regained better uncorrected visual acuity and showed reduced corneal astigmatism postoperatively. There was no evidence of residual or recurrent ingrowth throughout the follow-up period (case 1: 11 months, case 2: 1 month).
CONCLUSIONS
Combined mitomycin C-assisted photorefractive keratectomy and flap suturing can be an effective and safe method for treating and preventing the recurrence of thick, late-onset and long-standing epithelial ingrowth involving the visual axis.

Keyword

Epithelial ingrowth; LASIK complication; Mitomycin C; Phototherapeutic keratectomy

MeSH Terms

Adult
Astigmatism
Axis, Cervical Vertebra
Debridement
Epithelial Cells
Eye
Female
Follow-Up Studies
Humans
Keratomileusis, Laser In Situ
Lifting
Mitomycin
Nylons
Photorefractive Keratectomy
Recurrence
Sutures
Visual Acuity
Mitomycin
Nylons

Figure

• 

  Figure 1. Patient 1 has linear pattern epithelial ingrowth under the superonasal part of the corneal flap (A). The connection was observed between the epithelial Island and the flap edge without overlying melting of the flap edges (B). Two weeks after removal of the epithelial ingrowth, there is no evidence of residual or recurrent ingrowth but there is mild interface haze (C). Eleven months after surgery, there is no evidence of recurrent ingrowth (D). Epithelial ingrowth was elevating the flap and Orbscan corneal topograph showing irregular astigmatism (E). Eleven months after surgery, the topography is not regular but extensively changed and showed reduced corneal astigmatism postoperatively (F).

• 

  Figure 2. Patient 2 has island of the central epithelial ingrowth expanding toward the visual axis on the inferior margin of the pupil (A). Two weeks after removal of the epithelial ingrowth Patient 2 has mild interface haze but no residual or recurrent ingrowth (B). Extensive epithelial ingrowth was elevating the flap and Orbscan corneal topograph showing irregular astigmatism (C). More than 1 week after surgery, the topography is not regular but extensively changed and showed reduced astigmatism postoperatively (D).

Reference

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