Posters

Possible corneal epithelial ingrowth after ReLEx Smile and features of its destruction using ND-YAG laser

Poster Details

First Author: I.Dutchin RUSSIA

Co Author(s):    M. Pshenichnov                    

Abstract Details

Purpose:

In our latest reports, we presented method for treating epithelial ingrowth into the interface after refractive surgery to correct myopia using YAG laser (Ellex medical, Australia). It seems to us interesting to present the long-term treatment results in patients with such a rare complication at this technique as epithelial ingrowth under the "Cap". Purpose: to evaluate the effectiveness and safety of YAG laser destruction of epithelial ingrowth after ReLEx Smile and Femto Lasik methods.

Setting:

The work was performed in the Khabarovsk branch of the S.Fyodorov Eye Microsurgery Federal State Institution

Methods:

6 patients (6 eyes) aged 22 to 43 years. All operations were without complications. In all eyes corneal epithelial ingrowth was detected 1-3 months after refractive surgery (3 eyes after Femto-Lasik, 3 eyes after ReLEx Smile). Laser irradiation using a YAG laser “ULTRAQ” (Ellex medical), wavelength 1064 nm, was applied to remove epithelial ingrowth. Repeated sessions, if necessary, were carried out with interval of 2-3 weeks. Number of sessions varied from 1 to 5. The first patient, when the criteria for the adequacy of the effect on epithelial cells were still unclear, 5 sessions were performed.

Results:

Main criterion was the formation of a gas-vapor bubble occupying entire area of epithelial ingrowth. Interface state was evaluated on photo-slit lamp, using OCT of cornea. The planned visual acuity was achieved in all patients after treatment. After 1-1.5 years, the first patient showed a decrease in density of endothelial cells (Tomey EM3000) compared with paired eye: 1681 mm2 versus 2494 mm2, respectively. Biomicroscopically, cornea is transparent; minor, slight opacities are detected in the area of epithelial cell ingrowth. Remaining patients showed no difference in endothelial status compared to the paired eye. All patients are under dynamic observation.

Conclusions:

The use of YAG laser destruction is one of the effective methods of treatment of corneal epithelium ingrowth. The advantage of this technique is its ease of implementation, which is especially important after the ReLEx Smile technology. When carrying out laser exposure sessions, it is necessary to achieve criteria for the adequacy of exposure to ingrown epithelial cells; and, accordingly, strive to reduce the number of sessions, to monitor the dynamics of the endothelium state.

Financial Disclosure:

None