Introduction 

If you cut a flap in your cornea, it will leave a circumferential scar that is difficult to see without a microscope. Even years later, surgeons can take up the flap and do more laser vision correction because the junction between the flap and the underlying cornea never heals. The tissue at the front of your eye is permanently changed, and these modifications last your entire life. But as we age naturally, most people’s vision deteriorates over time. Your eyesight may become blurry as you age because LASIK cannot stop this. If the flap interface healed, you would have scar tissue in your field of vision, which would be very bad technically since you would not be able to see at all. 

The length of time it takes for LASIK recovery varies from patient to patient. However, it might be up to three months before the LASIK flap is fully healed. Within one week, the flap should be mostly healed and secure, at which point Patients can resume most routine activities. The quantity of keratocyte cells in the cornea is noticeably reduced in most LASIK patients. The cornea and the eye’s general health may be long-term damaged due to this decline.

Does Lasik leave a scar?

After epikeratoplasty, LASIK can cause corneal scarring and haze that are visually noticeable and necessitate corneal transplantation for vision recovery. Patients with a history of epikeratoplasty may still seek surgical options for vision correction even when the procedure is no longer performed. In these patients, it is advised considering surface ablation methods with MMC use and avoiding using a mechanical microkeratome if LASIK treatment is intended. For lasik treatment you can contact here: https://www.visualaidscentre.com/lasik-surgery-in-new-friends-colony/. In addition to the dangers of scarring and keratocyte migration, choosing to have LASIK following epikeratoplasty entails hazards.

    There is a chance of lenticule dislocation or injury when using a mechanical microkeratome over one. It is still needed to determine whether femtosecond LASIK combined with epikeratoplasty is safe and effective. Some worries using a femtosecond laser could also result in an ultrathin flap, which could cause the postoperative haze observed in ultrathin flaps with results comparable to our patient’s. However, as seen in this case in the patient’s left eye, even a thick LASIK flap into the host stroma can result in visible scarring. If femtosecond LASIK is used, targeting a thicker than typical flap may be a preferable alternative to avoid the lenticule completely. 

    In some situations, surface ablation may be a better alternative to LASIK for avoiding these risks. In some cases, surgeons may also use it to treat anterior scarring on the lenticule17; however, haze has developed after most PRK cases were performed after epikeratoplasty reported in the literature. In a new case series of 10 patients, doctors found topography-guided laser assistance in subepithelial keratectomy to enhance astigmatism and visual acuity with a 6-month follow-up. Scarring may result from corneal ulcers or other lesions that reach deeper than the epithelium.

    These scars will probably never disappear since the cornea’s inner layers do not regenerate like the outer epithelial layer. Although PRK takes longer to heal than LASIK, it can remove these scars because it targets both the stromal and Bowman’s layers beneath the eye’s surface. Epikeratoplasty followed by LASIK can result in corneal haze and scarring, necessitating corneal transplantation for visual rehabilitation. 

The after-effect of Corneal Incision

Corneal haze is a late side effect of excimer corneal surgery that often manifests as a fine reticular subepithelial pattern and can occasionally impair vision. The haze following PRK or LASIK is a corneal healing reaction brought on by the activation and migration of keratocytes (fibroblasts) and newly produced collagen. The haze often appears between 2 and 4 months after surgery and gradually disappears 6 and 12 months later. Rarely does a severe haze arise? Several variables, including corneal dryness during treatment, keratitis sicca, solar exposure, ablation depth, laser beam homogeneity, and epithelium removal technique, may cause increased haze. The corneal epithelial cells may eventually deteriorate in the flap interface’s metabolically “strange” environment after LASIK if they lose their distinctive morphological characteristics. The healthy cornea is separated from them simultaneously by a capsule of connective tissue resembling scar tissue. It has been proposed that keratocyte cell migration and scar formation are caused by an interaction between the epithelium and stroma mediated by cytokines. 

Today, I saw a patient with two right eye scars from ulcers brought on by contact lens usage at the LASIK facility. She wanted to know if the scars would still be there after LASIK. 

Can LASIK remove corneal scarring?

Corneal ulcers and other types of damage can occasionally leave scars if they extend through the epithelium’s layers. Given that the interior layers of the cornea do not regenerate like the outer epithelial layer, these scars will likely never fade. In most cases, these superficial scars do not pose a problem for LASIK unless they are very deep and thick, which may interfere with the flap’s formation. Although PRK has a longer recovery period than LASIK, it can eliminate these scars since it addresses both the stromal and Bowman layers. These scars can be removed by PRK, although it takes longer to recover than LASIK since PRK targets both the Bowman’s layers beneath the stroma and the outer layers. Most surgeons won’t alter their procedures to remove scars that don’t interfere with eyesight if they don’t disrupt vision, thus if the scars are not vision-impairing. 

LASIK is a safer and healthier alternative to contact lens wear for individuals with several corneal scars when I see them. This patient will likely be safer after a single surgical treatment than if they wear contact lenses continuously for the next 20 years. 

Conclusion

Following epikeratoplasty, LASIK might result in corneal scarring and haze, necessitating corneal transplantation for vision recovery. People with a history of epikeratoplasty may look for surgical alternatives to vision correction even though the surgery is no longer practiced. We advise considering MMC surface ablation therapies and avoiding mechanical microkeratomes if LASIK therapy is anticipated. Your surgeon will give you a few things after the procedure, such as eye drops.