Corneal wound healing after laser in situ keratomileusis flap lift and epithelial abrasion

We report the clinical and confocal microscopic findings of wound-healing reactions after epithelium debridement and flap lift for the treatment of folds in a thin laser in situ keratomileusis (LASIK) flap. A 30-year-old woman had a flap lift with deepithelialization because of persistent striae after LASIK. The patient developed stage 2 diffuse lamellar keratitis (DLK) and dense haze. Confocal microscopy showed a loss of the most anterior keratocytes 6 days after flap relifting and deepithelialization. Subsequently, stromal repopulation with the appearance of spindle-shaped fibroblasts and activated keratocytes was detectable. Two months postoperatively, a maximum of haze tissue was found at the interface level and a myopic shift of −2.00 diopters was observed. Under treatment with topical steroids, the haze resolved and the spherical equivalent returned to baseline within 12 months.