Different approaches in the management of post LASIK epithelial ingrowth: A tale of three eyes

Title : Different approaches in the management of post LASIK epithelial ingrowth: A tale of three eyes

Abstract:

Purpose: Post-LASIK epithelial ingrowth (PLEI) is an uncommon complication that is usually asymptomatic and does not warrant treatment. However, it can cause significant refractive error, dreadful complications, and flap melt in some patients. This is a prospective case series of three eyes with epithelial ingrowth which were managed using different approaches (flap lifting and scraping, Nd Yag Laser, Conservative approach).

Method: Eyes with epithelial ingrowth presenting to the outpatient clinic of refractive surgery department between September 2022 to February 2023 were included. A thorough clinical evaluation, visual acuity assessment, slit lamp photography, and anterior segment optical coherence tomography were done in all cases.

Result: All three eyes underwent blade LASIK more than 20 years back. Two eyes underwent LASIK re-do procedure and 1 eye had fingernail trauma. Out of the 2 eyes with enhancement, one underwent surgical flap lifting and scraping while the other was managed using Nd YAG laser. One eye with fingernail trauma was managed conservatively.

Conclusion: While some cases may need observation and close follow up others may need intervention. A customized tailored approach is needed in each case of PLEI.

Clinical Implication: The study highlights the various techniques utilized to treat Post-LASIK epithelial ingrowth with positive outcome.

Biography:

Dr. Tulika Chauhan, MBBS, MS, FIAS, FICO, is a Cornea and Refractive Surgery specialist with fellowships from Harvard’s Massachusetts Eye and Ear Infirmary and UCLA’s Jules Stein Eye Institute. An alumna of MGM Medical College, Indore, she has trained at leading institutes in India and abroad, including Johannes Gutenberg University, Germany. Her expertise covers LASIK/SMILE, cataract, corneal transplants, keratoprosthesis, ocular surface and stem cell disorders, and dry eye. A Senior Consultant at a reputed tertiary eye care centre, she has extensive surgical experience, published internationally, presented globally, and is actively involved in teaching, resident training, and developing case-based scientific programs.