Recalcitrant epithelial ingrowth in patients with compromised eyelid function.

Area of Science:

• Ophthalmology
• Corneal Surgery
• Refractive Surgery

Background:

• Laser-assisted in situ keratomileusis (LASIK) is a common refractive surgery.
• Epithelial ingrowth is a known complication following LASIK.
• Weak eyelid closure is a potential risk factor for LASIK complications.

Observation:

• Two patients with ipsilateral weak eyelid closure developed unilateral epithelial ingrowth after uncomplicated LASIK.
• Recalcitrant epithelial ingrowth was observed in one patient, requiring multiple surgical interventions.
• The second patient experienced recurrent epithelial ingrowth after initial removal.

Findings:

• Weak eyelid closure may predispose patients to poor flap adhesion and subsequent epithelial ingrowth.
• Surgical techniques like flap suturing and fibrin adhesive application were used to manage recurrent ingrowth.
• One patient achieved resolution of epithelial ingrowth after flap suturing.

Implications:

• Preoperative assessment of eyelid function is important in LASIK candidacy evaluation.
• Consideration of alternative refractive procedures like photorefractive keratectomy may be warranted in patients with weak eyelid closure.
• Understanding risk factors can help optimize surgical outcomes and patient selection for LASIK.