PURPOSE: To identify risk factors associated with primary and recurrent epithelial ingrowth after laser in situ keratomileusis (LASIK) requiring surgical debridement. METHODS: Charts of patients who required single or multiple surgical debridements of epithelial ingrowth were reviewed retrospectively and analyzed to identify preoperative, intraoperative, and postoperative risk factors. RESULTS: Fourteen of 22 patients had epithelial ingrowth that required a single surgical removal. These were mostly associated with the surgeon's learning curve, epithelial injury and enhancement by lifting the flap. Multiple surgical debridements were required in eight patients and some of these were associated with epithelial basement membrane degeneration and a history of type I diabetes. CONCLUSIONS: Refractive surgeons should be aware of surgical and non-surgical ocular and systemic risk factors associated with both primary and recurrent epithelial ingrowth after LASIK to appropriately consent patients seeking refractive surgery. Type I diabetes may increase the risk of epithelial downgrowth in LASIK.
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