Post-laser in situ keratomileusis (LASIK) epithelial ingrowth after interface fluid syndrome

Objectives: We present a case of epithelial ingrowth after late onset interface fluid syndrome, a rare complication after laser in situ keratomileusis (LASIK). Methods: This patient presented herself to the emergency department with corneal oedema due to endothelial failure after multiple intraocular surgeries. Anterior segment optical coherence tomography (OCT) showed a fluid filled pocket in the LASIK interface, 20 years after LASIK surgery. Results: As a result, she was diagnosed with late onset interface fluid syndrome which resolved after endothelial transplantation (DMEK). However, 3 months after surgery, epithelial ingrowth in the LASIK interface was noticed. We adopted a conservative approach as there was no progression after 3 weeks. Conclusions: Epithelial ingrowth is a rare complication after DMEK, which might be caused by interface fluid induced flap lifting and further facilitated by intraoperative flap manipulation during graft unfolding.