Topography-guided Transepithelial Surface Ablation in Treatment of Recurrent Epithelial Ingrowths

PURPOSE: To describe a new, single-step, transepithelial and trans-LASIK flap topography-guided surface ablation technique in a case of recurrent epithelial ingrowth with visual disturbances caused by irregular astigmatism, scattering, and decreased corneal transparency after LASIK. METHODS: Custom ablation through both the epithelium and the LASIK flap performed by 1-kHz flying spot excimer laser was used to transform an irregular corneal surface into a regular aspheric surface and in the same continuous process to ablate the epithelial ingrowth causing the irregularity. RESULTS: Visual rehabilitation was achieved, the corneal surface was regularized, and epithelial ingrowth was removed within the ablation. CONCLUSIONS: The transepithelial topography-guided surface ablation technique was safe and effective in this case of visually disturbing epithelial ingrowth after LASIK, and may also be applied to treat other types of flap/interface complications. [J Refract Surg. 2010;26(7):529-532.] doi:10.3928/1081597X-20100226-01