Abstract:AIM: To analyze the reason of corneal epithelial implantation and ingrowth after laser in situ keratomileusis(LASIK), and summarize the treatment experiences.
METHODS: The clinical data of postoperative corneal epithelial ingrowth on 18 cases(30 eyes)from 1 256 cases(2 256 eyes)after LASIK were retrospectively analyzed in our hospital from January 2008 to December 2012. After the treatment of all eyes, patients' general visual quality scores before and after treatment were analyzed.
RESULTS: There were 18 cases(30 eyes)with corneal epithelial implantation and ingrowth after LASIK, and the incidence rate was 1.3%. In the 18 cases(30 eyes), there were 12 eyes corneal flap epithelial ingrowth caused by postoperative trauma, 12 eyes caused by multiple corneal flap flush, 2 eyes caused by intraoperative irregular corneal flap, and nothing special for 4 eyes. The classification of corneal epithelial ingrowth of 30 eyes: grade Ⅰ, 11 cases(18 eyes); grade Ⅱ, 4 cases(8 eyes); grade Ⅲ, 3 cases(4 eyes). Grade Ⅰ-Ⅱ were treated with TobraDex eye drops and intraocular pressure lowering drug. Grade Ⅲ firstly were treated by drugs, otherwise by surgery if it didn't improve. After treatment, 8 cases(13 eyes)epithelial ingrowth disappeared from 11 cases(18 eyes), 3 cases(5 eyes)implanted epithelial tumor shrank in grade I; epithelial implantation of 2 cases(4 eyes)in grade Ⅱ disappeared, implantation degree of 2 cases(4 eyes)reduced to grade Ⅰ; 2 cases(2 eyes)in grade Ⅲ had 0.5~1mm wide flap edge shallow gray ribbon 1 mm inside the limbus, visual acuity was 0.8~1.2, 1 case(2 eyes)treated with curettage corneal epithelial implantation and endophytic epithelium hadn't relapsed in the follow-up. After the treatment, 18 cases of corneal epithelial ingrowth got lower visual quality scores than those before therapy(Hc=10.511, P<0.01).
CONCLUSION: Operation standardized, postoperative early detection and aggressive treatment are important for prevention and treatment of complications after LASIK.