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J.D. Lumba, M.C. Rojas, E.E. Manche; Treatment of Epithelial Ingrowth after Laser In Situ Keratomileusis with Mechanical Debridement and Suturing of the Flap . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2635.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To evaluate the efficacy and safety of mechanical debridement and suturing of the laser in situ keratomileusis (LASIK) flap in the treatment of clinically significant epithelial ingrowth after LASIK. Methods: In a retrospective study, 15 eyes of 15 patients that developed clinically significant epithelial ingrowth following LASIK were treated with lifting of the keratectomy flap, scraping of the epithelium from the posterior surface of the flap and the keratectomy bed, and apposition of the flap to the bed by sutures. Primary outcome measurements including recurrence of ingrowth, uncorrected visual acuity (UCVA), manifest refraction, best spectacle-corrected visual acuity (BSCVA), and complications were evaluated at the last postoperative examination. Results: Eight eyes (53.3%) had previous treatment before suturing of the flap was performed. Four eyes (26.7%) had more than one previous treatment. Previous treatments included lifting the flap and scraping the epithelial ingrowth in 7 eyes (46.7%), and lifting the flap, scraping the ingrowth, and treating with alcohol in 3 eyes (20.0%). Sutures were removed at a mean of 1.9 weeks (range, 1 to 3 weeks). At last follow-up (mean 5.3 ± 5.5 months; range, 2 weeks to 21 months), 100% of eyes had no recurrence of epithelial ingrowth. Mean spherical equivalent changed from –0.02 ± 0.81 diopters (D) (range, -1.12 to +1.00 D) preoperatively to –0.23 ± 0.59 D (range, -1.38 to +0.38 D) at last follow-up. UCVA improved from 20/20 or better in 5 eyes (33.3%) and 20/40 or better in 11 eyes (73.3%) preoperatively to 20/20 or better in 5 eyes (33.3%) and 20/40 or better in 13 eyes (86.7%) postoperatively. No eyes lost more than 2 lines of BSCVA. Conclusions: Suturing the LASIK flap in addition to mechanical debridement of epithelial ingrowth is a safe and effective treatment for primary or recurrent epithelial ingrowth following LASIK.
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