Rare findings after LASIK surgery
The contents of the section are intended for educational purposes only. In general, refractive surgery such as LASIK, PRK, SMILE, ICL, and Clear Lens Exchange surgery are extremely safe. I have personal confidence in refractive surgery, having undergone LASIK myself, and have recommended surgery to family, friends, and colleagues.
These photos are of patients that I have personally examined in my clinic. Some have had a longer recovery process, or required additional procedures. However, I have never had a patient permanently lose their vision after refractive surgery, and every patient has achieved a happy outcome.
-Jimmy Hu, MD
Epithelial Ingrowth after LASIK
LASIK Macrostriae
LASIK Macrostriae
Flap striae, or “folds” are a common consequence during recovery after LASIK surgery. Many striae are small and asymptomatic, but may also cause significant visual complaints, usually when the folds are large or involve the visual axis. Treatment is warranted when the patient’s vision is affected.
Early detection is key - when caught early, the LASIK flap can be re-lifted, hydrated, and smoothed out. If striae are detected late, or are persistent, correcting the patient’s visual issues from striae may require more invasive measures.
I have personally treated many patients with macrostriae, and thus far 100% have achieved 20/20 vision without issues.
Epithelial Ingrowth after LASIK with scarring
Epithelial Ingrowth after LASIK, when left untreated for prolonged periods of time may cause problems for the eye. The ingrown epithelial cells may proliferate (grow), and induce scarring, irregular astigmatism, and ultimately, blurry vision.
Epithelial nests with surrounding stromal scarring
Epithelial ingrowth nests with early scar formation (haze) around the nests of epithelial cells
Traumatic dislocation of LASIK flap, healed with folds and Epithelial Ingrowth
This patient was hit (directly) in the eye by her toddler’s toy, and suffered traumatic dislocation of her LASIK flap. Unfortunately, she wasn’t able to get an ophthalmologist to reposition the flap in a timely manner, and the flap folded in on itself (like folds of an accordion). Epithelial cells filled in the exposed space, and epithelial ingrowth developed within her LASIK flap folds. Weeks after the injury, the patient saw Dr. Jimmy Hu who then removed the epithelial ingrowth cells, un-folded the LASIK flap and smoothed out all the wrinkles.
Before surgery:
The LASIK flap was accordion-folded with epithelial ingrowth
Right after surgical repair
The LASIK flap was successfully unfolded. Loose epithelium is seen under the bandage contact lens. A single, 1mm central nest of epithelial ingrowth cells remains.
A happy ending!
The patient then underwent a re-lift of the LASIK flap to clean out the residual epithelial ingrowth, and recovered nicely. She was able to regain uncorrected 20/20 vision, with no recurrence of epithelial ingrowth, and some faint residual interface at the flap edge (that was not visually significant), which eventually faded over time.
Traumatic dislocation of a LASIK flap after a car accident
This patient suffered dislocation of his LASIK flap after a severe car accident. He couldn’t be seen by an ophthalmologist immediately because of other (more urgent) medical issues being addressed in the hospital. He presented to us in the office with both arms in casts.
There is a radial laceration through the LASIK flap into the corneal stroma (7 o’clock), and blood that has collected in the interface.
Before surgery:
The LASIK flap was partly torn, folded in some areas, with epithelial ingrowth and blood in the LASIK interface
Right after surgical repair
Dr. Hu was able to successfully unfold the LASIK flap, remove the epithelial ingrowth cells, and rinse out the blood.
A happy ending!
The patient was able to regain (uncorrected!) 20/20 vision . The scar from the radial corneal laceration through the LASIK flap remains, but isn’t visually significant for the patient. He continues to do well!
Traumatic Flap Dislocation
After LASIK, this patient rubbed his eyes and showed up to his post-op appointment with the LASIK flap out-of-alignment.
In addition to the large, exposed crescent of stroma that the LASIK flap didn’t cover, the flap itself had numerous striae causing distorted vision!
The patient was taken back to the laser suite, where the flap was re-positioned, and the striae were smoothed out. The patient recovered well and is back to 20/20 vision.