Table 3.
The summary of visual outcomes, recurrence rate and complications of various treatment modalities for postlaser in situ keratomileusis (LASIK) epithelial ingrowth
| Treatment | Study (year) | No. of eyes | Visual outcomes | R* | F/U, months (SD) | Complications |
| MD only | Wang and Maloney (2000)15 | 43 | 91% retained CDVA postoperatively | 23% | – | None |
| Rapuano† (2010)40 | 4 | CDVA=100%≥ 6/12; 25%≥ 6/7.5 | 0% | 16.5 (18.9) | None | |
| Henry et al (2012)42 | 45 | UDVA=53%≥ 6/7.5; CDVA=78%≥ 6/7.5 | 36% | 12 | None | |
| MD+diluted ethanol | Anderson and Hardten‡ (2003)43 | 3 | – | 100% | 5 | None |
| MD+50% ethanol | Haw and Manche (2001)44 | 4 | CDVA=100%≥ 6/7.5 | 0% | 3 | 2 DLK, resolved with topical CS |
| MD+70% isopropyl alcohol | Lahners et al (2005)45 | 22 | – | 36% | - | None |
| MD+ocular hydrogel sealant | Ramsook and Hersh (2015)46 | 2 | CDVA=100%≥ 6/9 | 0% | 1.5 | None |
| Yesilirmak et al (2015)47 | 1 | CDVA=6/6 | 0% | 6 | None | |
| MD+FG | Anderson and Hardte‡ (2003)43 | 3 | CDVA=100%≥ 6/6 | 0% | 5 | None |
| Yeh et al (2006)48 | 1 | UDVA=6/21 | 0% | 20 | None | |
| Hardten et al (2015)49 | 39 | UDVA=74%≥ 6/12; CDVA=85% ≥ 6/7.5 | 7.70% | 26.6 (17.0) | None | |
| MD+FG+70% ethanol+ 0.02% MMC |
Wilde et al (2017)50 | 4 | CDVA=100≥ 6/9 | 0% | 11.8 | None |
| MD+FS | Rojas et al (2004)51 | 20 | UDVA=45%≥ 6/6, 80%≥ 6/12 | 0% | 10.5 (14.3) | None |
| Rapuano† (2010)40 | 9 | UDVA=67%≥ 6/12;CDVA=67%≥ 6/12 | 22% | 16.5 (18.9) | 1 mild flap necrosis | |
| Güell et al (2014)13 | 13 | Mean UDVA=6/7.5 | 0% | 12 | None | |
| MD+FS+proparacaine | Spanggord et al (2005)52 | 6 | CDVA=67%≥ 6/12 | 33% | 12 | None |
| MD+FS+FG | Narváez et al (2006)53 | 1 | CDVA=6/6 | 0% | 15 | None |
| MD+AMG±FS±ethanol | Lee et al (2006)54 | 1 | CDVA=6/9 | 0% | 7 | None |
| Azar et al (2010)55 | 1 | UDVA=6/7.5 | 0% | 6 | None | |
| Kwon et al (2016)56 | 1 | CDVA=6/6 | 0% | 5 | None | |
| MD+PTK | Fagerholm et al (2004)57 | 5 | CDVA=100%≥ 6/12 | 20% | – | None |
| MD+PTK+AMG | Lee et al (2006)54 | 1 | UDVA=6/6 | 0% | 4 | None |
| Nd:YAG laser | Ayala et al (2008)58 | 30 | 80% disappearance of PLEI | 0% | 24 | None |
| Lindfield et al (2012)59 | CDVA=100%≥ 6/5 | 0% | 12 | None | ||
| Kim et al (2014)60 | 2 | UDVA=6/6 | 0% | 9 | None |
The majority of studies that specifically evaluated the treatment outcome of significant post-LASIK epithelial ingrowth (PLEI) are included in this table.
*Recurrence refers to rate of significant recurrence of epithelial ingrowth following the initial treatment.
†Rapuano reported 13 eyes of PLEI that underwent mechanical debridement, with 9 eyes being treated with additional flap suturing.
‡This study included three patients who were all initially treated with MD and diluted ethanol. However, all of them had a significant recurrence of epithelial ingrowth which required a further MD and application of fibrin glue.
AMG, amniotic membrane graft; CDVA, corrected distance visual acuity; CS, corticosteroids; DLK, diffuse lamellar keratitis; FG, fibrin glue; FS, flap suturing; MD, mechanical debridement; MMC, mitomycin C; Nd:YAG, neodymium: yttrium aluminum garnet; PTK, phototherapeutic keratectomy; UDVA, uncorrected distance visual acuity.