Alcohol and Mechanical Scraping for Epithelial Ingrowth Following Laser in situ Keratomileusis

Abstract

PURPOSE: To determine whether the use of 70% isopropyl alcohol is useful as an adjunct to simple mechanical removal of epithelial ingrowth following laser in situ keratomileusis (LASIK). METHODS: A retrospective comparison of two techniques of epithelial ingrowth removal following LASIK was performed. A total of 38 procedures on 31 patients were included. In one group, the epithelium was removed using a simple mechanical scraping technique and in the other, a similar technique combined with the application of 70% isopropyl alcohol was used. The rates of recurrence in the two groups were compared using a chi-square analysis. RESULTS: The total incidence of epithelial ingrowth recurrence in both groups was 57.9% (22/38). The incidence of clinically significant ingrowth recurrence in both groups was 34.2% (13/38). In the scrape group, the recurrence of any ingrowth was 43.8% (7/16) and the recurrence of clinically significant ingrowth was 31.3% (5/16). In the alcohol group, these rates were 68.2% (15/22) and 36.4% (8/22), respectively. The difference between the two groups did not show statistical significance in either comparison (P=.14 and P=.75, respectively). CONCLUSIONS: The use of 70% isopropyl alcohol showed no additional benefit over simple mechanical scraping in the removal and prevention of epithelial ingrowth recurrence following LASIK. [J Refract Surg. 2005;21:148-151.]

Inhibition of recurrence of epithelial ingrowth with an amniotic membrane pressure patch to a laser in situ keratomileusis flap with a central stellate laceration: a case report

“…Adjunctive treatments to lower this recurrence rate, however, did not result in a significant difference compared to the results of simple scraping. The use of 70 % isopropyl alcohol showed no additional benefit over simple mechanical scraping in the removal and prevention of epithelial ingrowth recurrence following LASIK [ 7 ]. Moreover, compared with mechanical debridement, some reports reported that alcohol can induce keratocyte death and increase inflammation [ 18 ].…”

September consultation #4

“…2 This can be combined with the application of diluted alcohol or mitomycin-C to reduce the chances of recurrence. 6 Flap suturing, fibrin glue, and ocular hydrogen sealant have been mentioned to improve flap adhesion to prevent recurrence. [7][8][9] I would advise a good talk with the patient about possible postoperative complications including reduced UDVA and recurrence of the epithelial ingrowth.…”

Epithelial ingrowth after LASIK September consultation #1

“…2 This can be combined with the application of diluted alcohol or mitomycin-C to reduce the chances of recurrence. 6 Flap suturing, fibrin glue, and ocular hydrogen sealant have been mentioned to improve flap adhesion to prevent recurrence. [7][8][9] I would advise a good talk with the patient about possible postoperative complications including reduced UDVA and recurrence of the epithelial ingrowth.…”