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First Author: J.Hughes THE NETHERLANDS
Co Author(s): I. van der Meulen C. Nieuwendaal R. Lapid-Gortzak
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Epithelial ingrowth is a rare occurence after LASIK surgery, but can have serious complications such as, deterioration of vision, flap melt, irregular astigmastism and incite to DLK. Nd:YAG epitheliolysis has been proposed as a treatment for epithelial ingrowth. In this case report we present a pictorial review of regression of dense epithelial ingrowth in the interlamellar space of a LASIK flap.
Interventional case report.
Case report: A 33 year old female who underwent LASIK surgery in 2005 with retreatment in 2008 to correct residual myopic error was referred to our tertiary clinic with decreased vision in her left eye after a blunt trauma. Ophthalmic examination revealed epithelial ingrowth in the periphery of the LASIK flap. A flap lift with mechanical debridement, flap suturing and fibrine glue was preformed twice followed both times by recurrence of ingrowth. The second occurence of ingrowth was densly opaque and centrally located. This new ingrowth was treated with the Nd:YAG laserin repeated sessions. After each session a front epithelial debris precipitated inferiorly from the original ingrowth and in the following weeks this front receeds revealing an increasingly smaller and less opaque laesion.
We report the use of NdYAG epiteliolysis in a case of dense central recurrent epithelial ingrowth. Nd:YAG epitheliolysis has been reported on, but not extensively. In our case report we show that repeated sessions of Nd YAG epithelyolysis is a viable method of treatment for recurrent aggressive and refractpory epithelial ingrowth. Side effects were minor, and included epithelial breakthrough and channel creation into the flap.