ESCRS - POREF060 - Tailored Management Of Post-Lasik Epithelial Ingrowth: Comparative Outcomes Of Conservative Therapy, Flap Lift With Scraping, And Nd:Yag Laser Treatment

Tailored Management Of Post-Lasik Epithelial Ingrowth: Comparative Outcomes Of Conservative Therapy, Flap Lift With Scraping, And Nd:Yag Laser Treatment

Published 2026 - 44th Congress of the ESCRS

Reference: POREF060 | Type: Free paper | DOI: 10.82333/sv6h-cn94

Authors: Dr Raghav Malik* 1 , Dr Mahipal Sachdev 1

1Cataract & Refractive Surgery,Centre For Sight,Delhi,India

Purpose

To describe and compare clinical outcomes of three distinct management strategies for post-LASIK epithelial ingrowth (EI), highlighting decision-making criteria and visual outcomes following conservative management, surgical flap lift with mechanical debridement, and Nd:YAG laser treatment.

Setting

Tertiary referral refractive surgery center.

Methods

This retrospective interventional case series includes three patients who developed epithelial ingrowth following LASIK. Each case differed in severity, location, and progression pattern. Management was individualized:

  1. Conservative management (topical corticosteroids, lubrication, and observation) for peripheral, non-progressive EI.

  2. Flap lift with mechanical scraping of stromal and undersurface epithelium for visually significant central ingrowth.

  3. Nd:YAG laser photodisruption targeting localized nests of epithelial cells at the interface.

Patients were followed for resolution of ingrowth, recurrence, interface clarity, and corrected distance visual acuity (CDVA).

Results

All three cases achieved complete resolution of epithelial ingrowth without long-term visual compromise.

  • The conservatively managed case demonstrated spontaneous stabilization without progression, maintaining 6/6 CDVA.

  • The flap lift and scraping case achieved full interface clearance with no recurrence during follow-up and restoration of 6/6 CDVA.

  • The Nd:YAG laser case showed regression of localized epithelial nests with preserved flap integrity and final CDVA of 6/6.

No sight-threatening complications or flap melts occurred. No recurrence was observed during the follow-up period.

Conclusions

Post-LASIK epithelial ingrowth requires individualized management based on severity and progression. Observation may be appropriate in stable peripheral cases, while flap lift and mechanical debridement remain effective for visually significant central ingrowth. Nd:YAG laser offers a minimally invasive alternative in selected localized cases. A tailored, severity-based approach can achieve excellent anatomical and visual outcomes while minimizing surgical morbidity.