PURPOSE: To present two cases with complications after Nd:YAG laser treatment of epithelial ingrowth. METHODS: Case reports. RESULTS: Dense central recurrent epithelial ingrowth was treated with a Nd:YAG laser directed at the epithelial nests in the LASIK flap interface in one case. Misalignment of the aiming beam after movement resulted in perforation of the LASIK flap, followed by renewed epithelial ingrowth through the new defect. The epithelial ingrowth receded and became more translucent as a result of the treatment, but the area of the perforation remained irregular. In another case, use of the Nd:YAG laser to treat recurrent epithelial ingrowth adjacent to the flap edge created a cavitation bubble that broke through the flap edge, creating a new epithelial channel through which ingrowth recurred. CONCLUSIONS: Surface breakthrough and renewed epithelial ingrowth is a possible complication of Nd:YAG laser treatment of epithelial ingrowth.
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