# Unusual visual impairment after enhancement refractive surgery

## TL;DR

A patient experienced rapid vision loss after enhancement eye surgery due to corneal epithelial in-growth, which was successfully treated.

## Contribution

Identifies a rare but rapid-onset complication of enhancement refractive surgery and highlights diagnostic methods.

## Key findings

- Visual acuity deteriorated rapidly within days after enhancement surgery.
- Corneal epithelial in-growth was diagnosed using corneal topography and OCT.
- Scraping ectopic epithelial cells restored corneal transparency and improved vision.

## Abstract

We reported a case of rapidly developed corneal epithelial in-growth (EI) deteriorating visual acuity (VA) within the initial postoperative day. A 37-year-old male presented with decreased VA for 2 years. He underwent LASIK surgery 13 years ago. After enhancement surgery, postoperative VA was much worse than preoperative best corrected visual acuity (BCVA) 20/20 and decreased rapidly. VA of OD was 20/40 on Day 1, and 20/70 on Day 5, OS 20/20 on Day 1, 20/25 on Day 10, and 20/50 on Day 13 postoperatively. Corneal topography and optical coherence tomography (OCT) showed distinctive features. The patient was diagnosed with corneal EI postoperatively. After scraping ectopic corneal epithelial cells, the cornea became transparent and VA improved. Despite its rarity, early postoperative EI can occur within 1 day after enhancement surgery and can progress rapidly. OCT and corneal topography provide distinctive manifestations aiding diagnosis.