ESCRS - PO466 - Desquamation Of The Corneal Epithelium During The Refractive Surgery. It's A "Minor Complication" Of Lasik, Isn't It?

Desquamation Of The Corneal Epithelium During The Refractive Surgery. It's A "Minor Complication" Of Lasik, Isn't It?

Published 2022 - 40th Congress of the ESCRS

Reference: PO466 | Type: Free paper | DOI: 10.82333/r26e-wr61

Authors: Jana Gertnere* 1 , Igors Solomatins 1

1dr. Solomatin Eye Center,Riga,Latvia

Purpose

To evaluate the effect of epithelial desquamation on the result of refractive surgery, to identify the main causes of this complication and to propose the most rational treatment tactics.

Setting

Microkeratome LASIK and Femto LASIK procedure were performed for the 14 patients (20 eyes).

Methods

  The retrospective analysis of the causes of epithelial desquamation was used in 14 patients (20 eyes). The observation period was 6 months. Subjective complaints, the state of the corneal epithelium, UCDVA and BCDVA visual acuity were assessed. Additionally, topographic examination of the cornea and OCT of the anterior segment of the eye. The tactics of conservative treatment (10 eyes) and delayed PTK (10 eyes) were compared.

Results

The main causes of epithelial desquamation during surgery were: asymptomatic epithelial basement membrane dystrophy, previous eye trauma, skin diseases such as psoriasis and dermatitis, age over 40 years. Restoration of the corneal surface was incomplete with the use of lubricants and root protectors. Violation of epithelium adhesion was observed at 1.3 and 6 months after surgery in 10 eyes. Subjective symptoms persisted. When using delayed PTK technology, the corneal surface was restored within 1 month (10 eyes).

Conclusions

Desquamation of the epithelium is a significant complication of refractive surgery. This problem can greatly affect patient satisfaction and lead to great disappointment with treatment outcomes. Restoration of the corneal surface takes a significant amount of time and may be incomplete even 6 months after surgery. Identification of risk factors is of great importance for the selection of patients before surgery and should help to choose the right tactics and method of vision correction. Surgical tactic of treating the complication by delayed PTK had an advantage in terms of recovery compared to conservative tactic.