Table 3.

Grading and Management of Epithelial Ingrowth (Probst and Machat grading)[88]

Grade	Signs	Location	Progression	Treatment
1	1-2 cell thick fine growth with a white demarcated line along progressing edge; Difficult to identify on slit-lamp examination	Within 2 mm of the flap edge	No	Not required
2	Thick growth showing discrete cells in the epithelial nest with no demarcation line; Flap edge may be rolled or grey in appearance	Within 2 mm of the flap edge	Yes	Required within 2-3 weeks
3	Several cells thick opaque ingrowth with no demarcation line; The flap may be rolled with whitish-grey appearance; Peripheral confluent haze at the flap edge	>2 mm from flap edge	Yes	Urgently required
4	Aggressive growth with epithelial cells advancing towards the visual axis; Flap melt may be present	Threatening/involving visual axis	Yes	Urgently required