Lasik in 2002, Epithelial Ingrowth, Neovascularization, now seeing 20/20 with GVR Scleral Lens

This patient underwent LASIK surgery on both eyes in 2002. A 2nd LASIK surgery was done on her left eye several months after the first procedure. In 2005, this patient’s vision in her left eye deteriorated to the point where eyeglasses and contact lenses were not able to help her obtain functional vision. When this patient first visited our practice we diagnosed corneal ectasia in both of her corneas. This condition is a relatively uncommon event seen in post-LASIK corneas years after the surgery was performed. It is characterized by a very distorted, irregular corneal surface. In addition, in the superior portion of her left cornea I noticed a gray arcuate haze above which were blood vessels extending onto the cornea from outside the cornea. These 2 conditions can be seen in the lower photo. The gray haze is a condition called epithelial ingrowth. This is due to the cells on the corneal surface getting underneath the LASIK flap. This is not a normal situation and must be monitored to make sure that these cells do not multiply, otherwise the LASIK flap must be lifted and the underlying epithelial cells cleaned out. The blood vessel growth visible in the superior cornea is known as “neo-vascularization.” This too must be monitored to make sure that an unstable situation does not come about. In 2008, we fit both eyes with GVR Scleral lenses which have allowed this patient to see clearly (20/20) and comfortably with all day lens wear. Over the last 7 years, the epithelial ingrowth and the neo-vascularization of her left cornea have remained stable. This patient’s eyes will not need to undergo any additional invasive procedures and I expect that she will be able to wear her lenses comfortably for many more years to come, however, yearly monitoring of her corneas are necessary.

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