Spontaneous resolution of delayed epithelial ingrowth after LASIK

Epithelial ingrowth is a known complication after laser in situ keratomileusis (LASIK), with a high incidence after repeat surgery or trauma. The authors report the occurrence of epithelial ingrowth 23 months after primary LASIK and its subsequent spontaneous resolution over the following 6 months.

A 35-year-old man underwent bilateral uneventful microkeratome-assisted LASIK in June 2008. The patient presented 23 months later after noticing a "white spot" in his left eye. Examination of the left eye showed an oval patch of epithelial growth in the superonasal quadrant. Uncorrected distance visual acuity (UDVA) was 1.0 OD and 0.6 OS. Topical fluorometholone 0.1% eye drops were prescribed four times a day. Over the next 2 weeks, the UDVA improved to 1.0 and the size of the interface opacities decreased slightly. However, no further change was observed with continuation of corticosteroid eye drops over the next 2 weeks. All treatment was stopped. Three months later, the epithelial ingrowth expanded toward the visual axis. An option of surgical intervention was refused by the patient.

Subsequent monthly follow-ups over another 3 months showed gradual decrease in the size of epithelial growth. Final slit-lamp examination showed complete clearance of the epithelial cells from the interface. The UDVA returned to 1.0 in the left eye.

Epithelial ingrowth can occur after a long interval after primary LASIK. In our case, the epithelial cells disappeared without any surgical intervention over a period of 6 months.