The number of laser in situ keratomileusis (LASIK) procedures is continuing to rise. Since its first application for correcting simple refractive errors over 25 years ago, the role of LASIK has extended to treat other conditions, including postkeratoplasty astigmatism/ametropia, postcataract surgery refractive error and presbyopia, among others. The long-term effectiveness, predictability and safety have been well established by many large studies. However, due to the creation of a potential interface between the flap and the underlying stroma, interface complications such as infectious keratitis, diffuse lamellar keratitis and epithelial ingrowth may occur. Post-LASIK epithelial ingrowth (PLEI) is an uncommon complication that usually arises during the early postoperative period. The reported incidence of PLEI ranged from 0%–3.9% in primary treatment to 10%–20% in retreatment cases. It can cause a wide spectrum of clinical presentations, ranging from asymptomatic interface changes to severe visual impairment and flap melt requiring keratoplasty. PLEI can usually be treated with mechanical debridement of the affected interface; however, additional interventions, such as alcohol, mitomycin C, fibrin glue, ocular hydrogel sealant, neodymium:yttriumaluminum garnet laser and amniotic membrane graft, may be required for recurrent or refractory cases. The aims of this review are to determine the prevalence and risk factors of PLEI; to describe its pathogenesis and clinical features and to summarise the therapeutic armamentarium and the visual outcome of PLEI.

Background: To assess the occurrence and magnitude of refractive change in pseudophakic eyes undergoing 20 gauge pars plana vitrectomy without scleral buckling and to investigate possible aetiological factors.

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Five patients with nephropathic cystinosis were evaluated to assess the ability of topical cysteamine to clear corneal cystine crystals. All patients were randomised to receive topical cysteamine 0.2% six times a day in one eye with normal saline in the other eye as a control. All five patients showed some improvement in visual symptoms (photophobia, blepharospasm and visual acuity) together with an improvement in corneal crystal density. Three of these also had an improvement in Snellen visual acuity and contrast sensitivity.

SUMMARYThree groups of patients were reviewed 1,2 and 3 years after extracapsular cataract extraction to assess the inci dence of problems related to nylon corneal sutures and the need for suture removal. A large percentage of patients were found to have suture-related problems and required or had previously undergone suture removal.These findings are analysed. The potential risk of sight threatening pathology associated with corneal sutures that are left in situ suggests that routine suture removal about 3 months after surgery is to be recommended. Jackson and Bosanquet" reported that a high percentage of patients whose sutures had not been removed had suture-related problems after the first year. We have tried to appraise the overall trends related to the problems asso ciated with corneal sutures in order to establish whether early routine removal is to be recommended. PATIENTS AND METHODSOne hundred and eighty patients (three groups of 60) who had undergone extracapsular cataract extraction 1, 2 or 3 years previously were invited to attend for review. A cor neal section had been performed on all patients and 10/0 nylon sutures (interrupted or continuous) used for closure.One hundred and fifty-eight patients attended and were RESULTSPatients reviewed were subdivided into groups according to their symptoms and the condition of their corneal sutures. Those who had had their sutures previously removed were grouped separately. Table I shows the breakdown for each year group. This information is illustrated graphically in Fig. 1. Abnormal physical signs attributable to loose or broken sutures were also recorded (Tables II, III After the second and third post-operative years this had risen to 72.2% and 87.5% respectively. The chi-squared test for trend is significant at p