Topography-guided transepithelial surface ablation in treatment of recurrent epithelial ingrowths

To describe a new, single-step, transepithelial and trans-LASIK flap topography-guided surface ablation technique in a case of recurrent epithelial ingrowth with visual disturbances caused by irregular astigmatism, scattering, and decreased corneal transparency after LASIK.

Custom ablation through both the epithelium and the LASIK flap performed by 1-kHz flying spot excimer laser was used to transform an irregular corneal surface into a regular aspheric surface and in the same continuous process to ablate the epithelial ingrowth causing the irregularity.

Visual rehabilitation was achieved, the corneal surface was regularized, and epithelial ingrowth was removed within the ablation.

The transepithelial topography-guided surface ablation technique was safe and effective in this case of visually disturbing epithelial ingrowth after LASIK, and may also be applied to treat other types of flap/interface complications.