Peripheral Melt of Flap after Laser in situ Keratomileusis

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Abstract
BACKGROUND: Laser in situ keratomileusis (LASIK) is an effective procedure to correct myopia. It may have complications related to the flap, such as epithelial ingrowth and stromal melt. METHODS: We report on a patient who developed extensive epithelial ingrowth and partial keratolysis of the flap following LASLK. This complication was treated by lifting the flap and removing the epithelium from within the interface. RESULTS: Progressive keratolysis (stromal melt) can result in irregular astigmatism and loss of vision as well as photophobia and ciliary injection. The pathogenesis is not completely understood although the epithelial ingrowth in the interface is always present, and epithelial-stromal interaction with production of proteases may be involved. CONCLUSION: Epithelial ingrowth may develop in the lamellar interface after LASLK and be associated with melting of the edge of the flap. This undesirable complication can be successfully managed with early surgical removal of the epithelium and proper attachment of the flap. [J Refract Surg 1998;14:61-63]