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Characteristic clinical findings and visual outcomes
Dimitri T Azar1, Amy Scally, Sadeer B Hannush
1Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA. dazar@meei.harvard.edu
Journal of Cataract and Refractive Surgery
|January 8, 2004
Summary
Epithelial ingrowth after laser in situ keratomileusis (LASIK) can mimic persistent epithelial defects, delaying diagnosis. Early detection is crucial to prevent vision loss from complications like stromal melting.
Area of Science:
- Ophthalmology
- Refractive Surgery
- Corneal Surgery
Background:
- Laser in situ keratomileusis (LASIK) is a common refractive surgery.
- Complications can arise, including those that mimic other conditions.
Observation:
- Four cases of epithelial ingrowth following LASIK are presented.
- Delayed diagnosis was attributed to stromal edema, diffuse lamellar keratitis, and flap contraction.
Findings:
- Epithelial ingrowth presented with specific clinical signs: peripheral epithelial convexity, fluorescein pooling, stromal edema, and reduced visual acuity.
- One case developed stromal scarring and ulceration requiring antibiotics.
- Surgical intervention involved epithelial scraping and flap ironing.
Implications:
- Epithelial ingrowth can masquerade as persistent epithelial defects after LASIK.
- A high index of suspicion is necessary for timely diagnosis.
- Delayed diagnosis can lead to irreversible vision loss due to stromal melting and infectious keratitis.