Clinical outcomes of epithelial ingrowth following laser in situ keratomileusis with mechanical debridement and compressed heating air fow: a case series

ABSTRACT Purpose: To describe the clinical outcomes of manual scraping of epithelial ingrowth followed by compressed heating air flow after laser in situ keratomileusis (LASIK). Methods: We underwent a retrospective, noncomparative, and interventional case series. Twenty eyes of 17 patients were included in this study. Each patient with a history of LASIK underwent epithelial removal with mechanical debridement followed by compressed heating air flow. Our primary outcome was the recurrence of epithelial ingrowth after 3 months of follow-up, while our secondary outcomes were uncorrected distance visual acuity, corrected distance visual acuity, and complications after surgery. Results: Ten patients (58.8%) were male, and eight eyes of seven (41.2%) patients underwent primary LASIK surgery, while12 eyes of 10 patients had flap-lift retreatment LASIK; sixteen eyes (80.0%) underwent mechanical microkeratome LASIK and four (20.0%) underwent femtosecond laser-assisted LASIK. Mean age at surgical removal of epithelial ingrowth was 37.0 years ± 9.3 years (range 24 to 55 years). There was recurrence of ingrowth in two eyes (10%) after 3 months of follow-up. The mean corrected distance visual acuity of patients before surgery was 0.07 ± 0.09 logMAR, and after the last follow-up was 0.02 ± 0.04 logMAR (p=0.06). The odds ratio of presenting with epithelial ingrowth after LASIK enhancement compared to primary LASIK was 29.41. Conclusion: Manual scraping followed by compressed heating air flow is a safe and effective treatment of clinically significant epithelial ingrowth after LASIK. At the last follow-up, no eye lost any line in corrected distance visual acuity.

摘要
研究目的：探讨准分子激光原位角膜磨镶术（laser in situ keratomileusis, LASIK）术后上皮植入经机械刮除联合压缩热气流治疗后的临床结局。
方法：本研究为回顾性非对照干预性病例系列研究，纳入17例患者共20只眼。所有有LASIK手术史的患者均接受机械清创去除上皮组织，随后辅以压缩热气流治疗。本研究的主要结局指标为随访3个月后的上皮植入复发情况，次要结局指标包括未矫正远视力、矫正远视力以及术后并发症。
结果：本研究中男性患者10例（58.8%）；7例患者共8只眼接受初次LASIK手术，10例患者共12只眼接受LASIK瓣掀开再治疗手术；16只眼（80.0%）接受机械微型角膜刀辅助LASIK，4只眼（20.0%）接受飞秒激光辅助LASIK。患者接受上皮植入刮除术时的平均年龄为37.0岁±9.3岁（范围24~55岁）。随访3个月后，共有2只眼（10%）出现上皮植入复发。患者术前平均矫正远视力为0.07±0.09 logMAR，末次随访时为0.02±0.04 logMAR（p=0.06）。与初次LASIK患者相比，LASIK增强术后发生上皮植入的比值比为29.41。
结论：机械刮除联合压缩热气流治疗LASIK术后临床显著上皮植入是一种安全有效的方法。末次随访时，所有患眼的矫正远视力均未出现视力下降。