Epithelial ingrowth in a corneal graft treated by laser in situ keratomileusis: Light and electron microscopy

Purpose: To demonstrate progressive epithelial ingrowth histopathologically in a human cornea after laser in situ keratomileusis (LASIK) and review its pathophysiology. Setting: Department of Ophthalmology, Medical College of Virginia Campus, Virginia Commonwealth University, and the Veterans Affairs Medical Center, Richmond, Virginia, USA. Methods: Tissue from a corneal transplant specimen was examined 6 weeks after LASIK by light and transmission electron microscopy. Results: Epithelial ingrowth in the flap interface with connection to the surface corneal epithelium was evident on light microscopy. In areas without epithelial ingrowth, the flap interface was imperceptible. Electron microscopy revealed minimal disruption of the stromal collagenous lamellae. Conclusion: Progressive epithelial ingrowth occurred with a continuous sheet of epithelium to the flap edge. Location of epithelial ingrowth and cytokine epithelial-stromal interaction appear to be important factors in this complication. Histopathological changes in the cornea after LASIK are difficult to detect in areas with normal wound healing. J Cataract Refract Surg 2000; 26:49-55 (C) 2000 ASCRS and ESCRS