Original Article

Epithelial Ingrowth After LASIK: Clinical Characteristics, Risk Factors, and Visual Outcomes in Patients Requiring Flap Lift

Christopher R. Henry, MD; Ana Paula Canto, MD; Anat Galor, MD; Pravin K. Vaddavalli, MD; William W. Culbertson, MD; Sonia H. Yoo, MD

  • Journal of Refractive Surgery
  • July 2012 - Volume 28 · Issue 7: 488-492
  • DOI: 10.3928/1081597X-20120604-01
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Abstract

PURPOSE:

To describe clinical characteristics, risk factors, and visual outcomes in patients requiring flap lift for epithelial ingrowth following LASIK.

METHODS:

Consecutive, noncomparative, retrospective case series of eyes requiring flap lift for epithelial ingrowth following LASIK from June 2003 through July 2011 at a tertiary care, university-based eye hospital. Main outcome measures were uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) at 1 and 3 months and recurrence of epithelial ingrowth.

RESULTS:

Forty-five eyes were included. Laser in situ keratomileusis retreatment was the most common etiologic factor for epithelial ingrowth (28/45 eyes [62%]). All patients were treated with flap lift and scraping. Mean logMAR UDVA at presentation was 0.28 (Snellen equivalent 20/38). Mean logMAR UDVA at 3 months was 0.17 (Snellen equivalent 20/30) with 53% of eyes 20/25 or better. Mean logMAR CDVA at 3 months was 0.06 (Snellen equivalent 20/23) with 78% of eyes 20/25 or better. Epithelial ingrowth into the central cornea portended a trend towards UDVA worse than 20/25 or worse at 3-month follow-up (hazard ratio [HR] 5.54, 95% confidence interval [CI]: 0.98–31.3, P=.05) and CDVA worse than 20/25 at 3-month follow-up (HR 4.32, 95% CI: 0.85–21.9, P=.08). Recurrence after treatment was 31% at 3 months and 36% at 1 year. Risk factors for recurrence included: infectious etiology of ingrowth (HR 5.7, 95% CI: 1.11–29.1, P=.04), use of microkeratome for primary LASIK (HR 4.64, 95% CI: 1.07–20.1, P=.04), and hyperopic primary LASIK (HR 2.49, 95% CI: 0.98–6.31, P=.06).

CONCLUSIONS:

Patients undergoing flap lift for the treatment of epithelial ingrowth have a relatively high rate of recurrence but good visual acuity outcomes.

AUTHORS

From Bascom Palmer Eye Institute, University of Miami Miller School of Medicine (Henry, Canto, Galor, Vaddavalli, Culbertson, Yoo); and Miami Veterans Administration Medical Center (Galor), Miami, Florida.

This work was supported by an unrestricted grant from Research to Prevent Blindness, New York, New York.

The authors have no financial or proprietary interest in the materials presented herein.

Correspondence: Anat Galor, MD, Bascom Palmer Eye Institute, 900 NW 17th St, Miami, FL 33136. Tel: 305.326.6000; Fax: 305.575.3312; E-mail: agalor@med.miami.edu

Received: March 23, 2012
Accepted: May 22, 2012
Posted Online: June 18, 2012

doi: 10.3928/1081597X-20120604-01

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