You already know what I think about LASIK.

Besides being unnecessary if holistic myopia control is practiced, it’s also dangerous.  The incidence rate of side effects is staggering.   Recurrence of myopia post LASIK is significant.   I may soften up about optometrists, but the LASIK charade has to go.

Here’s one of the many common complications.  Read through this if you’re considering getting your eyes cut up with a laser:

R. Doyle Stulting, MD, PhD: “About 50% of all LASIK patients will have post-op epithelial ingrowth by pathologic examination.” Source: EyeWorld, March 2006

Epithelial ingrowth or other problems from LASIK? File a MedWatch report with the FDA online. Alternatively, you may call FDA at 1-800-FDA-1088 to report by telephone, download the paper form and either fax it to 1-800-FDA-0178 or mail it to the address shown at the bottom of page 3, or download the MedWatcher Mobile App for reporting LASIK problems to the FDA using a smart phone or tablet. Read a sample of LASIK injury reports currently on file with the FDA.

Patients with LASIK complications are invited to join the discussion on FaceBook

Epithelial ingrowth images below courtesy of Dr. Edward Boshnick.


This eye in the photo below underwent 2 separate RK surgeries followed by 2 separate LASIK procedures. This patient’s last LASIK surgery was done in 2004. In 2013, a large colony of epithelial cells was discovered under the LASIK flap of her left eye. One year later this grouping of epithelial cells broke up and migrated to the central area of the cornea beneath the LASIK flap. The “glitter-like” appearance seen in this photo is actually epithelial cells that have migrated from the corneal surface to areas beneath the LASIK flap. A corneal specialist at a world famous eye institution declined recently to lift the LASIK flap to remove what is now cellular debris beneath the LASIK flap. (The bright white light seen in the left side of the photo is a reflection of the bulb in the microscope.) Click image to enlarge.

epithelial ingrowth

The photo below is an eye with post-LASIK epithelial ingrowth, which appears as a speckled white patch at the 7:00 position on the cornea. The patient had LASIK, followed by LASIK reoperation (enhancement), and subsequently developed epithelial ingrowth. It is common knowledge within the LASIK industry that LASIK reoperations carry a higher risk of epithelial ingrowth than primary LASIK. Patients who consent to LASIK reoperations should be warned of the increased risk of developing this potentially sight-threatening complication. This patient had corrective surgery to remove the epithelial ingrowth, which involved lifting the flap; however, the epithelial ingrowth returned. Click image to enlarge.

post lasik epithelial ingrowth

The photo below is a post-LASIK cornea with epithelial ingrowth and ectasia. The foreign object located in the perimeter of the cornea is an implantable plastic insert called INTACS, which was implanted in an attempt to flatten the ectasia protrusion. The t-shaped hazy white scar at the 9:00 position is from the incision which was made to insert the Intacs into the cornea. The milky line running from 7:00 to 8:00 is epithelial ingrowth. Click image to enlarge.

post lasik ectasia epithelial ingrowth Intacs

The photo below is the cornea of a patient who had LASIK in 2007. This cornea is extremely dry and irregularly shaped. In addition, epithelial cells from the outside surface of the cornea penetrated and grew under the LASIK flap. The cells can be seen as a white line extending from the lower cornea at 5:00 o’clock to 8:00 o’clock. The patient is wearing a specialty gas permeable scleral lens to protect the traumatized corneal tissue. Click image to enlarge.

post-LASIK epithelial ingrowth

The photo below is the cornea of a patient who had LASIK in Canada in 2009 and developed severe epithelial ingrowth. You can see the area of epithelial ingrowth from the 5:00 to 8:00 o’clock position. Cells from the outer layer of the cornea migrated underneath the LASIK flap. At this time it is not known if the cells will continue to proliferate under the flap. This cornea is extremely dry and irregularly shaped. The patient complains of foreign body sensation, sandy-gritty feeling, and constant burning. Patient also complains of distorted vision including starbursts, halos and glare. The epithelial ingrowth is easy to see, yet the LASIK surgeon who performed this surgery told the patient that there is nothing unusual about this eye, and that he cannot tell that the patient has had LASIK. Click image to enlarge.

2_yrs_post-LASIK_epi-ingrowth

The photo below is the cornea of a patient who has epithelial ingrowth following RK, RK enhancement, LASIK, and LASIK enhancement. The red arrow points to an RK incision that is still open. The green arrow points to the LASIK flap edge, which is not healed. The yellow arrow points to the pocket of epithelial ingrowth, which is a potentially sight-threatening complication. The patient has constant pain in addition to extremely blurred and distorted vision.

The two images below are photographs of the left eye of a professional baseball player who underwent LASIK surgery and subsequently developed epithelial ingrowth. In the top photograph, the red arrow points to a nest of epithelial cells in the interface between the flap and the underlying cornea. In the bottom image, white arrows point to epithelial cells growing under the flap along the flap margin. This patient has epithelial ingrowth in both eyes. Due to this condition he is unable to see well enough to hit the ball during night-time baseball games.

epithelial ingrowth

epithelial ingrowth along LASIK flap margin


The next image is a scan taken by Dr. Edward Boshnick of a post-LASIK cornea with epithelial ingrowth. This image was acquired with a Visante OCT anterior segment imaging scanner. This technology has many applications in diagnosing and treating patients with corneal disease or problems after refractive surgery. Click on image for a larger view.

post-lasik epithelial ingrowth
 
Avoid that procedure, if at all possible!
 
Cheers,
 
-Jake