Postoperative corneal epithelial ingrowth after femtosecond laser

Abstract

Objective To study the occurrence and prevention and treatment of corneal epithelial ingrowth after femtosecond laser assisted laser in situ keratomileusis (LASIK). Methods A retrospective analysis was performed on 1 122 patients (2 236 eyes) who underwent femtosecond laser surgery at our hospital from October 2013 to July 2014. BCVA>1.0 was found in a routine preoperative check. Intralase femtosecond laser at 60 kHz was used to complete the surgery and a digital camera was used to record the entire procedure. Patients were followed up for 3 months postoperatively to monitor corneal epithelial ingrowth. Results Corneal epithelial ingrowth occurred in 28 eyes (1.25%) by one month postoperatively. Of these, 18 eyes (0.81%) had level Ⅰ epithelial ingrowth. On the first day postoperatively 8 eyes (0.36%) had level Ⅱ epithelial ingrowth but did not appear to have local flap melting or irregular astigmatism. On postoperative day 1, two eyes (0.09%) had level Ⅱ diffuse lamellar keratitis. This condition disappeared after one week of applying 1% prednisolone acetate eyedrops 4 times a day, but at 1 month after surgery, they developed level Ⅲ epithelial ingrowth with corneal flap edge fusion. Conclusion The incidence of epithelial implantation was low after femtosecond laser surgery. A combination of preoperative screening, standardized surgery, close postoperative observation and timely treatment are effective means for the prevention and treatment of corneal epithelial endogenous. Key words: Femtosecond laser; Keratomileusis, laser in situ; Keratitis; Epithelial ingrowth