I had Lasik done on one eye about five years ago in order to see distances while driving. I have good close up vision in my right eye. I noticed that when I wear glasses the vision is slightly foggy in the Lasik eye. I had it checked out and was told it was Epithelial ingrowth. How common is this,..what causes it and can a second surgery correct it? I also noticed that at night the astigmatism is worse in the Lasik eye. All lights have a star shape around them.

The epithelium is the outermost layer of cells of the cornea. If you stick your finger on your eye, you are touching your epithelium. These cells are the most rapidly reproducing cells in the human body.

The process of LASIK includes the creation of a flap of cornea, folding the flap back, and replacing the flap. It is possible that some of these epithelial cells may get under the flap.

Cells do what cells do: divide and multiply. If the epithelial cells start growing under the LASIK flap, they will cause bumps in the flap. This is epithelial ingrowth and will provide vision that is out of focus.

In some cases, the epithelial cells will not continue to grow, die, and be absorbed by the cornea. In this case, no additional action is required by the surgeon other than to monitor the condition. If the cells do grow and if allowed to remain, the epithelial cells can starve the cornea from nutrients causing disintegration of the flap (flap melt).

The most common response is for your surgeon to lift the flap, wash out the area, and replace the flap. In some cases, the surgeon will apply a small amount of excimer energy to destroy any remaining cells.

Yours is an unusual circumstance because you are being diagnosed with epithelial ingrowth five years after LASIK. The obvious explanations would be that the cells have been there all along, but were not causing problems, the cells were "dormant" then became active (but I’ve never heard of this), or you suffered trauma to the eye recently. If none of these, I cannot speculate why they have occurred.

Glenn Hagele
Council for Refractive Surgery Quality Assurance
http://www.usaeyes.org

I am not a doctor.