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

Epithelial ingrowth is one of the relatively uncommon complications that can occur post-LASIK surgery. The incidence of epithelial ingrowth is about 1-2% in primary and microkeratome-assisted flap creation cases. The incidence is much lower in Femtosecond assisted flap cases. Multiple pre-operative and post-operative risk factors for epithelial ingrowth have been identified, including poor flap adherence and trauma.

A 38-year-old male presented with a homogeneous whitish mass under a flap of a previous LASIK surgery. Initially, the lesion was managed with a flap-lifting and an excisional biopsy. After 5 months from primary intervention, the patient presented with recurrence and was managed with flap amputation and mitomycin C application. Post flap amputation, patient reached 20/25 CDVA with clear cornea and minimal haze.

In this study, we present an unusual case of epithelial ingrowth post-LASIK refractive surgery presenting as a corneal cyst which was managed successfully with flap amputation. In this article we discuss the diagnostic process, treatment, and clinical implications.