Barzilai University Medical Center

76 Research Day 2020 Barzilai University Medical Center 54 RISK FACTORS FOR EPITHELIAL INGROWTH FOLLOWING MICROKERATOME-ASSISTED LASIK Kaiserman I 1 , Mimouni M 2 , Nemet AY 3 , Friehmann A 4 1 Department of Ophthalmology, Barzilai University Medical Center, Ashkelon and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel. 2 Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel. 3 Department of Ophthalmology, Wolfson Medical Center Holon, Israel. 4 Department of Ophthalmology, Meir Medical Center Kfar Saba, Israel. Background One of the severe complications of LASIK surgery is epithelial ingrowth under the LASIK flap Hypothesis One can identify various risk factors that affect the rate of epithelial ingrowth after LASIK Objectives To analyze the incidence and risk factors associated with epithelial ingrowth following uncomplicated microkeratome-assisted LASIK. Methods All patients who underwent microkeratome-assisted LASIK between January 2006 and December 2014 in a single surgical center were reviewed. Epithelial ingrowth cases were identified and associated factors were assessed. Results 149 of 30,574 cases developed epithelial ingrowth. The epithelial ingrowth group was older compared to controls (35.3 vs 31.7, P = .001) and had a higher percentage of moderate to high hyperopia (13.7% vs 5.3%, P < .001), early postoperative flap slippage requiring flap repositioning (9.4% vs 2.8%, P < .001), or flap lifting for enhancement (48.6% vs 4.3%, P < .001). They were treated with a smaller optic zone (6 mm) (37.7% vs 15.2%, P < .001), with a Moria M2 microkeratome, in a lower operating room temperature (22.3 vs 22.8, P = .005), and with a greater maximum ablation depth (67.3 vs 57.3, P < .001). There was a high incidence of epithelial ingrowth in the enhancement group compared to primary LASIK (4.8% vs 0.2%, P < .001). The time between treatments was significantly greater in the epithelial ingrowth group (1,110 vs 626 days, P < .001). There was a significant rise in epithelial ingrowth rates as time between primary and enhancement LASIK increased, peaking at 4 to 5 years (P < .001). Flap lifting for enhancement, 6-mm optic zone, moderate to severe hyperopia, greater ablation depth was associated with epithelial ingrowth (total R 2 = 15.4). Conclusions The potential risk factors described above may forewarn surgeons as to which individuals merit closer observation for this complication