The Analysis of Epithelial Ingrowth after LASIK Using a Femtosecond Laser

Hee Jin Jung; Sang Won Kim; Tae Hun Lee; Kyung Hun Lee

doi:10.3341/jkos.2011.52.12.1434

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Jung, Kim, Lee, and Lee: The Analysis of Epithelial Ingrowth after LASIK Using a Femtosecond Laser

Original Article

J Korean Ophthalmol Soc 2011;52(12):1434-1439.

Published online: 7 September 2011

DOI: https://doi.org/10.3341/jkos.2011.52.12.1434

The Analysis of Epithelial Ingrowth after LASIK Using a Femtosecond Laser

Hee Jin Jung, MD, Sang Won Kim, MD, Tae Hun Lee, MD, Kyung Hun Lee, MD

Sungmo Eye Hospital, Busan, Korea

Address reprint requests to Hee Jin Jung, MD Sungmo Eye Hospital #1078-7 Wu 2-dong, Haeundae-gu, Busan 608-838, Korea Tel: 82-51-743-0775, Fax: 82-51-743-0776, E-mail: kkiya75@hanmail.net

Received 2 November 201022 March 2011 Accepted 30 September 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To analyze the incidence and clinical course of epithelial ingrowth after laser in situ keratomileusis (LASIK) using a femtosecond laser.

Methods

We retrospectively evaluated the results of 1158 eyes of 581 patients who received LASIK with the flap created by a femtosecond laser from February 2006 to March 2009 at our institute. We investigated the incidence and clinical course of LASIK in which the flap was created by a femtosecond laser.

Results

Epithelial ingrowth was first detected one week after surgery in 12 (57%) of 21 eyes and within one month in 19 eyes (90%). Epithelial ingrowth was localized most commonly near the temporal and nasal flap edge in 12 eyes (57%). In two eyes (9.5%), an isolated ingrowth mass was located in the pupillary area. The development of more than 2.0 mm of epithelial ingrowth was observed in three eyes (0.25%). Among 28 eyes with loose epithelium or epithelial detachment during surgery, epithelial ingrowth was observed in six eyes (21.4%) compared with 15 (1.32%) of 1130 eyes without loose epithelium or epithelial detachment. Therefore, epithelial detachment during surgery was significantly associated with epithelial ingrowth (p = 0.00).

Conclusions

In LASIK in which the flap is created by a femtosecond laser, damage to the epithelial layer increases the chances of epithelial ingrowth. Therefore, avoiding epithelial defects with a gentle maneuver is needed to reduce the chance of epithelial ingrowth during surgery.

Keywords: Epithelial ingrowth, Femtosecond laser, LASIK

References

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Figure 1.

Isolated ingrowth mass was located in the pupillary area.

Figure 2.

Epithelial ingrowth was located in hinge area.

Figure 3.

Epithelial ingrowth does not improve or aggravate. (A) 8 days after LASIK. (B) 22 days after LASIK.

Figure 4.

BCVA & Post OP mean spherical equivalent.

Figure 5.

Incidence of epithelial detachment in epithelial ingrowth group and in no ingrowth group. There was significant relationship between incidence of epithelial detachment and epithelial ingrowth (p=0.00).

Table 1.

Demographic data of patients

Age (yr)	28.6 ± 4.2
Male:female (eye)	372 : 786
SE (Diopter)	-4.58 ± 2.32

SE = spherical equivalent.

Table 2.

Onset time of epithelial ingrowth of LASIK

Onset	Number of eyes (%)
One week after surgery	12 (57)
One week to 1 mon	7 (33)
One month to 2 months	2 (10)
Two months to 6 months	0 (0)

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