Management of Detached Lenticule in Case of Extensive Epithelial Ingrowth Following Automated Lamellar Keratoplasty

ABSTRACT

Detachment of a keratomileusis lenticule or extensive epithelial ingrowth is a difficult complication to amnage. Seven cases of extensive interfacial epithelial ingrowth were occurred following in situ keratomileusis or laser in situ keratoileusis. After the removal of epithelial ingrowth, we tried to reattach the lenticule to the stromal bed by drying the cap with air, or by suturing using interrupted sutures or double running sutures. Three detached cases were applied with air dry, only one case was reattached. Two other cases were failed due to epithelial ingrowth along the interface. In spite of the interupted sutures, the epithelial ingrowth along the interface recurred. In one of them, the edge of the lenticule was burried into the stroma and the lenticule was attached to the cornea leaving a ring-shaped opacity peripherally. In the other four cases, the lenticule was attached to the cornea successfully without epithelial ingrowth along the interface with double running sutures. Detached lenticules with extensive epithelial ingrowth following keratomileusis can be managed successfully by double running suture technique.