Prevalence of Epithelial Ingrowth and Other Complications Following Refractive Enhancement Surgery

Theme: Cornea, external disease & refractive surgery
What: Cornea, external disease & refractive surgery
Part of: Cornea III: Refractive surgery and keratoconus / Cornée III: Refractive surgery and keratoconus
When: 5/31/2024, 04:15 PM - 05:45 PM
Where: Room | Salle 713 AB

Abstract

Purpose:  The purpose of the study was to evaluate visual outcomes and complications amongst varying techniques of excimer laser enhancement procedures. 

Study Design: Retrospective Chart Review

Methods:  This retrospective chart review included 101 eyes who underwent refractive enhancement surgery in 2022.  We excluded patients for which details of the original refractive surgery were not available, or for enhancement procedures in patients with a history of cataract or refractive lens exchange surgery. Procedures were grouped into 4 groups: femtosecond laser LASIK  relifts (Group 1, n=71); PRK retreatments (Group 2, n=13); femtosecond laser LASIK post PRK (Group 3, n=15) and PRK post femtosecond LASIK (Group 4, n=2). The study compared complication rates and visual outcomes at 1-week, 1-month, 3-months, and 6-12-months following the between the different types of enhancement procedures.

Results:  Within Group 1, epithelial ingrowth was reported in 41% (29/71) of patients by 1-month. Epithelial ingrowth was more common if the enhancement was performed more than 1 year after the original refractive surgery (46 vs. 29%). However, all cases were self-limiting, with none requiring treatment. Corneal haze was reported in 2/71 eyes in Group 1 vs. 2/23 in Group 2 with all cases resolving over 12 months.  Other complications included grade 1 DLK (2/71 eyes in Group 1), microstriae (8/71 eyes in Group 1), and a flap tear (1 patient in Group 3). At 6-12 months follow-up, the spherical equivalent was within 0.5D of target in 75% of patients in group 1 vs. 63% of patients within Group 2.

Conclusions:  Excimer laser retreatments are generally safe procedures.  When the original surgery is made by femtosecond LASIK, relift enhancement is a safe procedure that provides a faster patient recovery; while epithelial ingrowth is common we found no cases for which treatment was required.  The small sample size of other enhancement procedures prevented a robust intergroup comparison of visual outcomes and complications.

Presenter(s)

Presenting Author: Mohamed Gemae

Additional Author(s):

Davin Johnson, Kingston Health Sciences Center

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