Posters

Variants of corneal epithelium ingrowths after ReLEx SMILE and description of their destruction by Nd:YAG laser

Poster Details

First Author: I.Dutchin RUSSIA

Co Author(s):    M. Pshenichnov                    

Abstract Details

Purpose:

Currently, ReLEx Smile is widely used to correct myopia, there are many reports in the literature about the results of this technology and possible complications. It seems interesting to us to present our experience in treating patients with a rare complication - ingrowth of the epithelium under “Cap”. Purpose: to analyze variants of corneal epithelium ingrowth after ReLEx Smile and evaluate the features of its destruction using ND-YAG laser.

Setting:

The work was performed in the Khabarovsk branch of the Federal State Autonomous Institution «S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery» of the Ministry of Health of the Russian Federation

Methods:

3 cases (3 eyes): all operations of the ReLEx Smile were without complications. In two patients after 1 month on examination: ingrowing epithelium in opposite side of incision. In one patient the next day after surgery: epithelial defect in the incision area, which was closed the next day. After 1 month: epithelium ingrowth directly in the area of incision. To remove ingrown epithelium, we used laser treatment method with ULTRAQ ND: YAG laser, wavelength 1064 nm, power 0.3-0.4 mJ. The impact was directly over the entire area of the ingrown epithelium under the “Cap” till formation of vapor-gas bubble.

Results:

Two variants of ingrowing epithelium into interface. The first (2 patients) is characterized by asymptomatic course. Epithelial cells enter interface during surgery, ingrowth is detected a month later. The mechanism of ingrowth in this case is associated with the importation of epithelial cells during surgery with a tool. It took 4 sessions of destruction, intervals: 2 weeks - 1 month. The second variant - epithelium growth directly in incision area, which is caused by local cornea de-epithelization in incision area in early postoperative period due to weak epithelial adhesion. It took 2 sessions of YAG-destruction, the gap - 1 month.

Conclusions:

We have identified two variants of epithelium ingrowth into the interface after ReLEx Smile. Depending on the type of ingrowth, the number of sessions of YAG-destruction can vary. The advantage of the YAG-destruction of the ingrown epithelium is the effectiveness, ease of implementation and atraumatic impact, which is especially important after the ReLEx Smile.

Financial Disclosure:

None