Management of Post LASIK Epithelial Ingrowth | Cornea Colours | Season-2 | Ep-5 скачать в хорошем качестве

Management of Post LASIK Epithelial Ingrowth | Cornea Colours | Season-2 | Ep-5

Welcome to Cornea Colours, aiming to simplify complex corneal surgeries with key insights, from basics to advanced techniques. Learn, grow, and excel with us. Epithelial ingrowth into the corneal flap interface is a rare complication of LASIK, occurring in approximately 1% of primary cases and 2% of enhancement cases with microkeratome-assisted flap creation. While often asymptomatic, it can lead to vision impairment due to irregular astigmatism, invasion into the visual axis, or flap melting. Poor flap adhesion or apposition allows epithelial cells to migrate into the flap-stromal interface. Signs 1. Nests of cells near the flap edge. 2. Fibrosis in chronic cases. 3. White cell plaques in the interface. 4. Irregular astigmatism. 5. Fluorescein staining at the flap border. General Treatment • Flap lifting. • Scraping epithelial cells from the stromal bed and flap undersurface. Surgical Steps Case 1 • Debridement around flap edges. • Flap edge scored and separated using BSS injection. • Resistance encountered during separation due to epithelial ingrowth. • Flap lifted, epithelial cells identified, and stromal bed cleaned. • Epithelial cells scraped from the stromal bed and flap undersurface with a No. 15 blade. • Flap edges carefully scraped to prevent recurrence. • Thorough irrigation of the interface with BSS. • Flap repositioned and ironed using a Merocele sponge (nasal-to-temporal pattern). • Bandage contact lens (BCL) placed post-surgery. Case 2 • Liquified epithelial cells identified. • Alcohol-assisted epithelial removal (absolute alcohol applied for ~30 seconds). • Epithelial debridement performed with a No. 15 blade. • Flap scored, separated, and cleaned of liquified epithelial cells. • Residual bed and flap undersurface meticulously cleaned. • Flap repositioned, ironed, and secured with a BCL. Key Points: • Complete removal of epithelial cells is crucial to prevent recurrence. • Flap and stromal integrity must be preserved throughout the procedure. 𝗗𝗶𝘀𝗰𝗹𝗮𝗶𝗺𝗲𝗿: This video is meant for the education of eye specialist. The treatment should be done by ophthalmologist based on their own clinical judgement.