Epithelial ingrowth in a corneal graft treated by laser in situ keratomileusis: light and electron microscopy.

PURPOSE: To demonstrate progressive epithelial ingrowth histopathologically in a human cornea after laser in situ keratomileusis (LASIK) and review its pathophysiology.

SETTING

Department of Ophthalmology, Medical College of Virginia Campus, Virginia Commonwealth University, and the Veterans Affairs Medical Center, Richmond, Virginia, USA.

METHODS

Tissue from a corneal transplant specimen was examined 6 weeks after LASIK by light and transmission electron microscopy.

RESULTS

Epithelial ingrowth in the flap interface with connection to the surface corneal epithelium was evident on light microscopy. In areas without epithelial ingrowth, the flap interface was imperceptible. Electron microscopy revealed minimal disruption of the stromal collagenous lamellae.

CONCLUSION

Progressive epithelial ingrowth occurred with a continuous sheet of epithelium to the flap edge. Location of epithelial ingrowth and cytokine epithelial-stromal interaction appear to be important factors in this complication. Histopathological changes in the cornea after LASIK are difficult to detect in areas with normal wound healing.