Fibrin adhesive in conjunction with epithelial ingrowth removal after laser in situ keratomileusis: Long‐term results. Issue 7 (July 2015)

• Record Type: Journal Article
• Authors: Hardten, David R.; Fahmy, Mona M.; Vora, Gargi K.; Berdahl, John P.; Kim, Terry
• Is Part Of: Journal of cataract and refractive surgery. Volume 41:Issue 7(2015)
• Publication Date: 2015-07
• Subjects: 617.7
• DOI: 10.1016/j.jcrs.2014.10.031
• Languages: English
• ISSNs: 0886-3350

Abstract

Abstract : Purpose : To describe the long‐term results of fibrin adhesive use in the management of epithelial ingrowth after laser in situ keratomileusis (LASIK). Setting : Private practice, Minneapolis, Minnesota, and an academic medical center, Durham, North Carolina, USA. Design : Retrospective case series. Methods : Patients with a history of LASIK had epithelial ingrowth removal with mechanical debridement and fibrin glue application. Visual outcomes and the presence or absence of epithelial ingrowth were evaluated again after 3 months and at the last follow‐up. The main outcome measures were recurrence of epithelial ingrowth and visual acuity. Results : Thirty‐nine eyes of 38 patients were evaluated. After epithelial ingrowth removal and application of fibrin glue, 31 eyes (79.5%) had no recurrence of ingrowth at the final follow‐up and 5 eyes (12.8%) had mild epithelial ingrowth not requiring removal. Three eyes (7.7%) had significant epithelial ingrowth at the 3‐month follow‐up that required subsequent removal and fibrin application. At the 3‐month follow‐up visit, 76.9% of eyes achieved 20/25 or better corrected distance visual acuity (CDVA) and 69.2% of eyes achieved 20/40 or better uncorrected distance visual acuity (UDVA). At the last follow‐up visit (mean 26.6 ± 17.0 months [SD]), 84.6% of eyes had 20/25 or better CDVA and 74.4% of eyes had 20/40 or better UDVA. Conclusions : Fibrin adhesive in conjunction with manual epithelial removal prevented a clinically significant recurrence of epithelial ingrowth in the majority of eyes. Larger randomized studies are needed to compare the success of this technique with that of others. Financial Disclosure : No author has a financial or proprietary interest in any material or method mentioned.