Surgical removal of post-LASIK epithelial ingrowth: Does technique matter?

This retrospective study evaluated visual outcomes and recurrence rates after surgical removal of epithelial ingrowth (EI) after laser in situ keratomileusis (LASIK).

Study design

Investigators compared 2 different techniques for managing EI among 67 eyes of 54 patients over a 15-year period at a single institution. A total of 56 eyes (83.6%) had flap lift + scraping alone, while 11 eyes (16.4%) underwent flap lift + scraping + suturing.

Outcomes

After a follow-up of 1 to 2.5 years, 11 of 56 eyes (19.6%) in the flap lift + scraping group had EI recurrence, whereas no eyes in the flap lift + scraping + suturing group had recurrent ingrowth. At 1 month, there was a statistically significant greater amount of cylinder in the suturing group compared with the scraping-only group. Even though vision and refractive errors were better in scraping-only eyes, the difference between groups did not reach statistical significance.

At 1-year, there was no difference in visual acuity, refractive error or cylinder between groups.

Limitations

Differences in recurrence rates between surgical techniques did not reach statistical significance due to the small sample size in the suturing group.

Clinical significance

Suturing flaps after lifting and scraping for removal of epithelial ingrowth led to lower recurrence rates compared with lifting and scraping alone. Predictably, eyes with suturing had increased levels of astigmatism in the early postop period with worse 1-month vision results, but at 1 year the visual and refractive results including astigmatism were similar between groups.