Flap amputation for severe epithelial ingrowth presenting as a corneal cyst: a case report

Area of Science:

• Ophthalmology
• Refractive Surgery
• Corneal Surgery

Background:

• Epithelial ingrowth is an uncommon complication following LASIK surgery, with varying incidence based on flap creation methods.
• Risk factors include poor flap adherence and trauma, necessitating careful patient selection and post-operative care.
• Femtosecond laser-assisted flap creation is associated with a lower incidence compared to microkeratome-assisted flaps.

Purpose of the Study:

• To present an unusual case of LASIK-induced epithelial ingrowth presenting as a corneal cyst.
• To discuss the diagnostic approach and successful management of this rare complication.
• To highlight clinical implications and treatment strategies for post-LASIK epithelial ingrowth.

Main Methods:

• A 38-year-old male with a corneal cyst post-LASIK underwent initial flap lifting and excisional biopsy.
• Recurrence led to subsequent management with flap amputation and mitomycin C application.
• Visual acuity and corneal clarity were assessed post-treatment.

Main Results:

• Initial management with flap lifting and biopsy did not prevent recurrence of epithelial ingrowth.
• Flap amputation combined with mitomycin C application resulted in successful resolution of the corneal cyst.
• The patient achieved 20/25 corrected distance visual acuity with a clear cornea and minimal haze post-treatment.

Conclusions:

• Epithelial ingrowth can manifest unusually as a corneal cyst after LASIK.
• Flap amputation is an effective surgical option for managing recurrent or complex epithelial ingrowth.
• Successful outcomes emphasize the importance of tailored treatment strategies for managing LASIK complications.