May 2004
Volume 45, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2004
Using an Amniotic membrane Pressure patch to treat the LASIK flap with a Central defect and Epithelial ingrowth
Author Affiliations & Notes
  • E.–K. Kim
    Institute of Vision Research, Dept. Ophthalmology, Yonsei Univ College of Med, Seoul, Republic of Korea
    Brain Korea 21 Project for Medical Science, Yonsei University, Seoul, Republic of Korea
  • S. Jung
    Institute of Vision Research, Dept. Ophthalmology, Yonsei Univ College of Med, Seoul, Republic of Korea
    Brain Korea 21 Project for Medical Science, Yonsei University, Seoul, Republic of Korea
  • J. Park
    Daegu Yonsei Eye Clinic, Daegu, Republic of Korea
  • S.M. Cristol
    Dept. Ophthalmology, Emory Univ., Atlanta, GA
  • C.Y. Im
    Institute of Vision Research, Dept. Ophthalmology, Yonsei Univ College of Med, Seoul, Republic of Korea
  • K.Y. Seo
    Institute of Vision Research, Dept. Ophthalmology, Yonsei Univ College of Med, Seoul, Republic of Korea
  • H. Lee
    Institute of Vision Research, Dept. Ophthalmology, Yonsei Univ College of Med, Seoul, Republic of Korea
  • Footnotes
    Commercial Relationships  E. Kim, None; S. Jung, None; J. Park, None; S.M. Cristol, None; C.Y. Im, None; K.Y. Seo, None; H. Lee, None.
  • Footnotes
    Support  02–PJ1–PG1–CH02–0003
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 188. doi:
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      E.–K. Kim, S. Jung, J. Park, S.M. Cristol, C.Y. Im, K.Y. Seo, H. Lee; Using an Amniotic membrane Pressure patch to treat the LASIK flap with a Central defect and Epithelial ingrowth . Invest. Ophthalmol. Vis. Sci. 2004;45(13):188.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Abstract: : Purpose: To report a new successful treatment of epithelial ingrowth occuring under a LASIK flap with a central defect by pressure patching with amniotic membrane. Methods: Two cases of epithelial ingrowth through a central defect in the LASIK flap were referred after failure of therapeutic contact lens treatment. In patient 1, the flap was bisected by a poor microkeratome incision 5 days earlier. The cut margin was elevated by the epithelium under the flap (Fig., upper left). In patient 2, the microkeratome had produced a very thin flap with only the epithelial layer in the central flap. Laser ablation had been done at the remaining posterior stroma. The central flap had melted and perforated; the epithelium had been growing into the interface for 5 months (Fig., upper right). Each flap was lifted and the epithelium was removed. In patient 2, phototherapeutic keratectomies of 6 mm in diameter were performed on the posterior flap and on the stromal bed for 30 pulses. An amniotic membrane pressure patch (epithelial side against the cornea) was sutured to the episclera under tension, using interrupted 10–0 nylon sutures. The amniotic membrane patch was removed 5–6 days after application. Results: Both flaps were attached to the remaining posterior stroma without recurrent epithelial ingrowth after removal of amniotic membrane. Visual acuity improved in patient 1 from 20/70 to 20/25 (Fig., lower left) and in patient 2 from 20/100 to 20/25 (Fig., lower right). Conclusions: Epithelial ingrowth in the central cornea following LASIK can be treated with amniotic membrane pressure patch. The elasticity of the membrane maintains the anatomic relationship between the flap and the stromal bed and prevents recurrence of the epithelial ingrowth.  

Keywords: refractive surgery: LASIK • refractive surgery: complications • cornea: stroma and keratocytes 
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