PERIPHERAL MELT OF FLAP AFTER LASER IN-SITU KERATOMILEUSIS

BACKGROUND: Laser in situ keratomileusis (LASIK) is an effective proce dure to correct myopia. It may have complications related to the flap, such as epithelial ingrowth and stromal melt. METHODS: We report on a patient who developed extensive epithelial ingrowth and partial herat olysis of the flap following LASIK, This complication was treated by l ifting the flap and removing the epithelium from within the interface. RESULTS: Progressive keratolysis (stromal melt) can result in irregul ar astigmatism and loss of vision as well as photophobia and ciliary i njection, The pathogenesis is not completely understood although the e pithelial ingrowth in the interface is always present, and epithelial- stromal interaction with production of proteases may be involved. CONC LUSION: Epithelial ingrowth may develop in the lamellar interface afte r LASIK and be associated with melting of the edge of the flap. This u ndesirable complication can be successfully managed with early surgica l removal of the epithelium and proper attachment of the flap.