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

Abstract

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.

Histopathological Findings of Epithelial Ingrowth After Laser In Situ Keratomileusis

“…The affected lesion increased in intensity with time, suggesting that these lesions have considerable proliferating activity. Histopathological examination for such specimens in our cases was consistent with previous investigations for epithelial ingrowth after LASIK [10][11][12][13] and epithelial ingrowth after other surgeries, such as cataract extraction, keratoplasty, or penetrating trauma. 14,15 Histopathological examination in the aforementioned specimens showing normal multilayered squamous epithelium with cuboidal basal cells partly with basement membrane-like structures and flatter cells resembling wing cells or superficial cells suggest that cells in the lesion may differentiate with polarity as in the corneal epithelium.…”

“…[10][11][12][13] In these reports, the authors succeeded in demonstrating multilayered corneal epithelial cells between the corneal flap and underlying stroma. Only one case with small old epithelial ingrowth described by Naoumidi et al that was examined 5 years after initial LASIK surgery showed homogeneous masses without any evidence of cellular materials.…”

Immunohistochemical characterization of epithelial cells implanted in the flap–stroma interface of the cornea

“…10 Some investigators believe that epithelial nests, which remain connected to the flap edge, may disappear without consequences, 11 while others believe that solitary colonies of epithelial cells are capable of transient proliferation and growth while free of peripheral connections. 12 We developed an animal model of epithelial ingrowth after LASIK and showed that implanted epithelium can survive more than 1 month without peripheral connections.…”

Histopathological and immunohistochemical findings after hyperopic LASIK

“…Weltweit werden pro Jahr schatzungsweise weit mehr als eine Million solcher Operationen durchgefiihrt [1,2]. Trotz aller Begeisterung fur diese refraktive Operationstechnik konnen sowohl intra-als auch postoperativ zahlreiche Komplikationen auftreten, die bis zu einer Keratoplastik fuhren konnen [3][4][5][6][7]. Histopathologische Untersuchungen nach LASIK insbesondere nach Hyperopiebehandlung wurden bisher nur aul3erst selten durchgefiihrt and zwar hauptsachlich bei Tierversuchen [8][9][10].…”