lasik surgeons

 

USAEyes is a nonprofit Lasik patient advocacy organization
USAEyes in the news!
 
How to Pick
A Lasik Doctor
۰ Certified Lasik Doctor
۰ Why Choose USAEyes
 
Certified Lasik Doctors
۰ 50 Tough Questions For
  Your Lasik Doctor
 
Ask Lasik Expert
۰ Lasik Q&A Forum
 
Lasik
Top Articles
۰ Lasik Results
۰ All About Lasik
۰ Lasik Cost
۰ Wavefront Custom Lasik
۰ Lasik Patient Survey
 
Lasik Alternative
Top Articles
۰ Monovision Lasik
۰ PRK, LASEK, Epi-Lasik
۰ RLE Lens Exchange
 

Digg, Del.icio.us, Reddit, Bookmark, etc. this page.

Add Lasik page to Digg, Del.icio.us, Reddit, My Favorites, Facebook, Ask, and others.

 

Lasik Doctors

 

Epithelial Ingrowth

Complication after Lasik and All-Laser Lasik.


Lasik Epithelial Ingrowth
Epithelial Ingrowth after Lasik appears as whitish islands in the cornea when illuminated.

 

Epithelial ingrowth is a relatively benign complication of conventional or custom wavefront Lasik and All-Laser Lasik that can resolve on its own or may require the Lasik flap to be lifted and the cells removed.

The epithelium is the outermost layer of cells of the cornea, just under the tear film. If you stick your finger on your eye, you are touching your epithelium. These cells are the most rapidly reproducing cells in the human body.

The process of conventional or custom wavefront Lasik and All-Laser Lasik includes the creation of a flap of corneal stroma tissue, folding the flap back, applying laser energy to the exposed cornea, and replacing the flap. It is possible that epithelial cells may get under the flap.

PRK, LASEK, Epi-Lasik, RLE, P-IOL, and NearVision CK do not have this Lasik stromal flap and are not subject to epithelial ingrowth.

Cells do what cells do: divide and multiply. If the epithelial cells start growing under the Lasik flap, they can cause bumps in the flap. This is called epithelial ingrowth and may provide vision that is out of focus.

In some cases, the epithelial cells will not continue to grow, will die, and will be absorbed by the cornea. In this case, no additional action is required by the doctor other than to monitor the condition.

If the cells do grow and if allowed to remain, the epithelial cells can starve the cornea from nutrients causing disintegration of the flap (flap melt).

The most common resolution for epithelial ingrowth is for the doctor to lift the flap, wash out the area, and reposition the flap. In some cases, the doctor will apply a small amount of excimer energy or a diluted alcohol solution to destroy any remaining cells. It is uncommon, but if necessary multiple flap lifts can be performed to resolve stubborn epithelial cell ingrowth.

If you are ready to choose a doctor to be evaluated for conventional or custom wavefront Lasik, All-Laser Lasik, PRK, LASEK, Epi-Lasik, NearVision CK, RLE, or any refractive surgery procedure, we highly recommend you consider a doctor who has been evaluated and certified by the USAEyes nonprofit organization. Locate a USAEyes Evaluated & Certified Lasik Laser Eye Surgery Doctor.

If this article did not fully answer your questions, use our free Ask Lasik Expert patient forum.


Current Epithelial Ingrowth Medical Journal News...

Clinical and Histopathologic Features of Failed Descemet Stripping Automated Endothelial Keratoplasty Grafts.

Related Articles

Clinical and Histopathologic Features of Failed Descemet Stripping Automated Endothelial Keratoplasty Grafts.

Cornea. 2009 Apr 29;

Authors: Lee JA, Djalilian AR, Riaz KM, Sugar J, Tu EY, Wadia H, Edward DP

PURPOSE:: To study the histopathologic features of Descemet stripping automated endothelial keratoplasty (DSAEK) grafts removed after graft failure and to correlate with relevant clinical features. METHODS:: Retrospective study of 8 cases in 7 patients who experienced DSAEK graft failure during the surgeons' learning phase. Perioperative clinical findings were correlated with pathologic findings of the explanted graft specimens. Imaging software was used to measure the central and peripheral thickness of each graft. RESULTS:: Graft failure occurred in association with graft detachment or excessive surgical manipulation. In 4 cases, the donor tissue detached, including 2 cases with routes for bubble escape. In 3 cases, the graft remained attached but failed to clear. The mean preoperative DSAEK button thickness was 205 +/- 61.8 mum. Average death to preservation time was 8 hours 47 minutes, and average preservation to surgery time was 2 days 22 hours. By light microscopy, explanted donor tissue showed varying degrees of keratocyte degeneration and marked endothelial cell loss. Two specimens with bubble escape had less endothelial loss, and 1 specimen showed epithelial ingrowth at the interface. Repeat keratoplasty (5 DSAEK, 2 penetrating keratoplasty) was successful in 6 of 7 cases. CONCLUSIONS:: This series correlates factors that may play a role in DSAEK failure with histopathologic features of explanted DSAEK lenticules. Marked endothelial loss was common in cases with surgical trauma but was less in cases with bubble escape. One specimen showed an epithelial membrane on the stromal interface. Outcomes of repeat DSAEK in these patients seem promising.

PMID: 19421044 [PubMed - as supplied by publisher]

 

Technorati Tags:

Last updated Monday, June 22, 2009

"Consider and Choose With Confidence" TM

A few of the communities where Lasik doctors are certified by USAEyes :

Materials presented in this website are for informational purposes only and are not medical advice. See full Terms of Use.
Unless otherwise indicated, Copyright 1997-2009 © Council for Refractive Surgery Quality Assurance, a nonprofit organization.
8543 Everglade Drive, Sacramento CA 95826-3616, USA, 800/USA-Eyes
No images, graphics, or text may be reproduced in any media without express written permission.
USAEyes, CRSQA, ComplicatedEyes, Council for Refractive Surgery Quality Assurance,
50 Tough Questions For Your Lasik Doctor, and Consider and Choose With Confidence are trademarks of the
Council for Refractive Surgery Quality Assurance
All Rights Reserved.