Epithelial ingrowth through venting incision into laser-assisted in situ keratomileusis flap interface after descemet stripping automated endothelial keratoplasty

PURPOSE: To present a case of epithelial ingrowth into the laser-assisted in situ keratomileusis (LASIK) flap interface after a patient underwent descemet stripping automated endothelial keratoplasty (DSAEK) surgery with venting incisions. OBSERVATIONS: We present a case of a 48-year-old man with previous history of LASIK that underwent DSAEK for pseudophakic bullous keratopathy after complicated cataract surgery requiring an intraocular lens (IOL) exchange. The patient developed epithelial ingrowth into the LASIK flap interface from one of the venting incisions. The epithelial ingrowth was observed as it was a small peripheral area that did not affect his visual acuity. CONCLUSIONS AND IMPORTANCE: Epithelial ingrowth is a well-described complication following LASIK but has rarely been described to occur after endothelial keratoplasty (EK). Even rarer, are reports of epithelial ingrowth after EK cases that have been found to result from venting incisions. To the authors’ knowledge, this is the first case of the ingrowth into a LASIK flap interface occurring after EK through a venting incision. Although it may be an uncommon occurrence in which a patient with a history of LASIK requires EK, surgeons should take extra precautions to avoid this complication.