Recalcitrant epithelial ingrowth in patients with compromised eyelid function.

Purpose: To report recalcitrant unilateral epithelial ingrowth in two patients with ipsilateral weak eyelid closure.

Methods: Two patients with weak eyelid closure who underwent simultaneous, uncomplicated LASIK developed unilateral epithelial ingrowth.

Results: Eight months postoperatively, one patient presented with right-sided epithelial ingrowth. One month after removal, more extensive epithelial ingrowth was noted and removed, and the flap gutters were sealed with fibrin adhesive. Epithelial ingrowth recurred 1 week later. The epithelial ingrowth was removed and the flap was secured with concurrent placement of radial 10-0 nylon sutures. No further epithelial ingrowth recurred. In the second patient, epithelial ingrowth was noted in the left eye 4 months postoperatively. Eight months later, the ingrowth was removed with subsequent recurrence in 2 weeks.

Conclusions: Weak eyelid closure may be a predisposing factor to poor flap adhesion and epithelial ingrowth. Close attention to lid function may be of importance in deciding between LASIK and photorefractive keratectomy, particularly in patients with other risk factors for epithelial ingrowth.