Clinical experience in the treatment of epithelial ingrowth after keratorefractive surgery
DOI: 10.32364/2311-7729-2026-26-2-17
Clinical experience in the treatment of epithelial ingrowth after keratorefractive surgery
N.V. Maychuk1,2, V.L. Timokhov2, M.R. Obraztsova2, O.V. Zaitseva2
1National Institute of Myopia, Moscow, Russian Federation
2Hippocrates Medical Center LLC, Khimki, Russian Federation
Background: epithelial ingrowth is a serious complication following laser vision correction. Its pathogenesis is multifactorial. When epithelial cell nests are located within the corneal optical zone and demonstrate progressive growth, posing a threat to central vision, a decrease in visual acuity may occur, including as a result of induced irregular astigmatism. Accordingly, identifying an optimal treatment strategy for eliminating epithelial ingrowth and its associated complications remains a relevant clinical challenge in keratorefractive surgery.
Aim: to evaluate the efficacy and safety of a combined laser-surgical approach for the treatment of epithelial ingrowth in patients after keratorefractive procedures.
Patients and Methods: 8 patients (8 eyes) with epithelial ingrowth beneath the corneal flap were examined. A two-stage treatment strategy was used, consisting of YAG laser disruption of epithelial ingrowth followed by removal of debris from the corneal interface via a created tunnel, with subsequent conservative therapy. Postoperative treatment included topical ocular antiseptics, a topical glucocorticosteroid (0.5% loteprednol etabonate), artificial tear substitutes, and a hypertonic saline solution. Follow-up evaluations were performed at 1, 3, and 6 months after treatment.
Results: at initial presentation, all eyes were quiet, with no signs of active inflammation on biomicroscopy. Clusters of epithelial cells were visualized as gray, cloud-like opacities without clear demarcation lines, located in various regions of the interface and at the peripheral margin of the corneal flap. No intraoperative or postoperative complications were observed. Following the two-stage treatment approach described above, no epithelial cell accumulations were detected in the interface, and no recurrence of epithelial ingrowth was observed during the follow-up period. Patients reported good tolerability of the conservative treatment phase, with no signs of intolerance, toxic or allergic reactions. No cases of intraocular pressure elevation associated with loteprednol etabonate use were identified.
Conclusion: YAG laser disruption combined with corneal tunnel formation is an effective, safe, and minimally invasive method for the treatment of epithelial ingrowth, offering a high probability of successful outcomes with minimal complications.
Keywords: cornea, keratorefractive surgery, complication; epithelial ingrowth, Nd:YAG laser disruption.
For citation: Maychuk N.V., Timokhov V.L., Obraztsova M.R., Zaitseva O.V. Clinical experience in the treatment of epithelial ingrowth after keratorefractive surgery. Russian Journal of Clinical Ophthalmology. 2026;26(2):195–201 (in Russ.). DOI: 10.32364/2311-7729-2026-26-2-17
About the authors:
Nataliya V. Maychuk — Ophthalmologist, Ophthalmic Surgeon, C. Sc. (Med.), Associate Professor of the Department of Ophthalmology, National Institute of Myopia; 63B, bldg. 2, Mikhalkovskaya str., Moscow, 125438, Russian Federation; Head of Hippocrates Medical Center LLC; 7, Molodezhnaya str., Khimki, 141407, Russian Federation; ORCID iD 0000-0001-8740-3766
Vladimir L. Timokhov — Ophthalmologist, Ophthalmic Surgeon, Hippocrates Medical Center LLC; 7, Molodezhnaya str., Khimki, 141407, Russian Federation; ORCID iD 0000-0003-1720-2082
Maria R. Obraztsova — C. Sc. (Med.), Ophthalmologist, Ophthalmic Surgeon, Hippocrates Medical Center LLC; 7, Molodezhnaya str., Khimki, 141407, Russian Federation; ORCID iD 0000-0002-9933-9754
Oksana V. Zaitseva — Ophthalmologist, Ophthalmic Surgeon, Hippocrates Medical Center LLC; 7, Molodezhnaya str., Khimki, 141407, Russian Federation; ORCID iD 0009-0008-4218-8060
Contact information: Maria R. Obraztsova, e-mail: obraztsova.maria@mail.ru
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 13.02.2026.
Revised 10.03.2026.
Accepted 31.03.2026.
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