Anterior stromal puncture in the treatment of loose epithelium after LASIK.

PURPOSE

To describe anterior stromal puncture, with or without a bandage contact lens, as a means to treat LASIK epithelial defects and potentially reduce the likelihood of secondary diffuse lamellar keratitis (DLK).

METHODS

Six eyes of five LASIK patients had their microkeratome pass complicated by loose epithelium, central in one case. After repositioning the flap, a 25-gauge needle on a tuberculin syringe was used to puncture the anterior corneal stroma to just beneath Bowman's layer in the affected area of irregular epithelium. A bandage contact lens was placed on two eyes, including the one with loose epithelium centrally.

RESULTS

Normal appearance of the corneal epithelium was noted by postoperative day 1; no eye developed DLK or significant epithelial ingrowth postoperatively. All eyes achieved > or = 20/20 vision.

CONCLUSIONS

By obviating, in select cases, the need for bandage contact lenses, anterior stromal puncture could increase patient comfort and remove a potential source of infection.