Epithelial ingrowth after femtosecond laser-assisted in situ keratomileusis

To describe the incidence and clinical features of epithelial ingrowth after femtosecond laser-assisted in situ keratomileusis (LASIK).

All eyes with clinically significant epithelial ingrowth were identified from patients who underwent primary femtosecond laser-assisted LASIK and their subset of patients who underwent enhancement procedures from January 2005 to March 2007 at Kudret Eye Hospital. Clinical course in terms of severity, type of epithelial ingrowth, time of appearance, effect on visual acuity, and treatment was described for each patient.

Two eyes of 6415 eyes after primary procedure and 2 eyes of 108 eyes after enhancement procedure developed clinically significant epithelial ingrowth. All eyes were treated with surgical removal of epithelial ingrowth. The epithelial ingrowths in all the patients were seen as solitary islands of cells, with a size ranging between 1 and 3 mm, beneath the flap with no connection with the surface epithelium. There was recurrence of ingrowth in 1 eye.

Visually significant epithelial ingrowth after femtosecond laser-assisted LASIK is an infrequent complication. The lower incidence of epithelial ingrowth after femtosecond LASIK surgery compared with mechanical microkeratome-assisted LASIK may be attributed to the anatomy of the femtosecond laser-created side cut in contrast to that created with a mechanical microkeratome and the creation of less peripheral trauma at the time of flap creation.