Post-laser in situ keratomileusis (LASIK) epithelial ingrowth after interface fluid syndrome

TL;DR

A rare case of epithelial ingrowth after late onset interface fluid syndrome following LASIK surgery is reported, with resolution through DMEK and conservative management.

Contribution

Reports a rare case of epithelial ingrowth after late onset interface fluid syndrome following LASIK and DMEK.

Findings

Late onset interface fluid syndrome was diagnosed 20 years after LASIK and resolved with DMEK.

Epithelial ingrowth occurred 3 months after DMEK but showed no progression with conservative management.

Interface fluid may cause flap lifting and facilitate epithelial ingrowth during DMEK.

Abstract

We present a case of epithelial ingrowth after late onset interface fluid syndrome, a rare complication after laser in situ keratomileusis (LASIK).

This patient presented herself to the emergency department with corneal oedema due to endothelial failure after multiple intraocular surgeries. Anterior segment optical coherence tomography (OCT) showed a fluid filled pocket in the LASIK interface, 20 years after LASIK surgery.

As a result, she was diagnosed with late onset interface fluid syndrome which resolved after endothelial transplantation (DMEK). However, 3 months after surgery, epithelial ingrowth in the LASIK interface was noticed. We adopted a conservative approach as there was no progression after 3 weeks.

Epithelial ingrowth is a rare complication after DMEK, which might be caused by interface fluid induced flap lifting and further facilitated by intraoperative flap manipulation during graft unfolding.

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