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Surgical Epithelial ingrowth <1% of cases Recurrence rate 44% Ref : Wang MY, AJO 2000 Purpose

Prevention of epithelial ingrowth recurrence . Faik Orucov MD, Frederik Raiskup MD, Abraham Solomon MD, David Landau MD, Joseph Frucht-Pery MD. Cornea and Refractive Surgery Service Hadassah University Hospital Jerusalem Israel. Surgical Epithelial ingrowth <1% of cases Recurrence rate 44%

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Surgical Epithelial ingrowth <1% of cases Recurrence rate 44% Ref : Wang MY, AJO 2000 Purpose

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  1. Prevention of epithelial ingrowth recurrence .Faik Orucov MD, Frederik Raiskup MD, Abraham Solomon MD, David Landau MD, Joseph Frucht-Pery MD.Cornea and Refractive Surgery Service Hadassah University Hospital JerusalemIsrael

  2. Surgical Epithelial ingrowth <1% of cases Recurrence rate 44% Ref:Wang MY, AJO 2000 Purpose To describe the outcome of a new surgical approach for treatment of epithelial ingrowth.

  3. STUDY GROUP 9 patients – 5 females/4 males [19-56 yo] • significant epithelial ingrowth > 2.5mm • Symptoms Blurred vision, Decreased night vision, Discomfort – dryness, FB • UCVA 20/20 – 20/50 REASONS FOR EPITHELIAL INGROWTH • 4 patients - post primary LASIK • 4 patients - post enhancement • 1 patient – post traumatic dehiscence • Follow-up: 9 mo. to 5 years

  4. Surgical Technique • The flap was divided by a 10-0 stitch into two segments, that allows to lift one segment of the flap at a time • Breaking the marginal flap-epithelium over the epithelial ingrowth • Lifting one segment of the flap Removal of the epithelial ingrowth Segment washout with BSS Replacement and suturing with 10-0 nylon sutures • Lifting the second segment of the flap and doing the same procedure if needed

  5. SURG. PROCEDURE 1 segment lifted - 6 eyes 2 segments lifted - 3 eyes Focused removal of epithelial ingrowth [only 1 min.] Stromal bed exposure: only 2-4 minutes. Results POSTOP. OUTCOME • 24-48 hours : -minimal hyperemia -mild flap edema • No DLK • Stitches removed: 7-14d • No recurrence of epithelial ingrowth • UCVA: 20/20 – 20/30 • No loss of BCVA

  6. Conclusions Reducing the surgical exposure time and the area of the stromal bed with appropriate suturing of the flap, may reduce the postoperative inflammatory process and prevent the recurrence of epithelial ingrowth.

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