Titel | 27-year-old man with "corneal opacity" after a branch injury |
Doel | Case of a patient with epithelial ingrowth after injury and laser in situ keratomileusis (LASIK). |
Methodes | A 27-year-old patient was referred for "corneal opacity" after a branch injury in the left eye. The patient reported a decrease in visual acuity in the affected eye. He had undergone a LASIK surgery on both eyes to treat a moderate hyperopia. The best corrected visual acuity (BCVA) was 0.4 in the affected left eye. Slit-lamp biomicroscopy showed an isle-like invasion of epithelial cells under the LASIK flap from the nasal flap edge to the optical axis as well as a paracentral lenticular fold. We made the diagnosis "posttraumatic LASIK flap folding with epithelial ingrowth (grade 4 according to Probst/Machat)". |
Resultaten | Mechanical removal of the epithelium from the bed and flap posterior surface in combination with 0.02% mitomycin C for 60 seconds was performed. Additionally, the flap margins were fixed with 3 temporary 10-0 nylon single sutures. Postoperative therapy consisted of topical and systemic steroids. BCVA increased to 1.0. No recurrence of epithelial invasion occurred after 4 months. |
Conclusie | Epithelial ingrowth is a rare postoperative complication after LASIK. The term "corneal opacity" should be avoided as a finding or diagnosis. In cases of progressive epithelial ingrowth, urgent surgical intervention is indicated, regardless of the degree of visual loss. Diffuse lamellar keratitis (DLK) should always be excluded as a differential diagnosis. |
Belangenverstrengeling | Nee |
Naam | HAMON |
Initialen | L |
Instituut | Saarland University Medical Center (UKS) |
Stad | Homburg/Saar, Germany |
Naam | FLOCKERZI |
Initialen | E |
Instituut | Saarland University Medical Center (UKS) |
Stad | Homburg/Saar, Germany |
Naam | ARDJOMAND |
Initialen | N |
Instituut | Sehzentrum für Augenlaser und Augenchirurgie |
Stad | Graz, Austria |
Naam | SEITZ |
Initialen | B |
Instituut | Saarland University Medical Center (UKS) |
Stad | Homburg/Saar, Germany |
Naam | DAAS |
Initialen | L |
Instituut | Saarland University Medical Center (UKS) |
Stad | Homburg/Saar, Germany |