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Epithelial ingrowth at the edge of the flap is one of the most significant complications of LASIK. Reports of the incidence of epithelial ingrowth have ranged from 0 to 20 % [1–4]. It usually presents in the early postoperative period and is known to be associated with loose epithelium, epithelial defects at the time of surgery, hyperopic LASIK correction, enhancement surgeries, flap instability, and corneal epithelial basement membrane dystrophy [1, 3–5]. While not always serious, it can progress to induce irregular astigmatism or melting of the overlying flap and threaten the central vision.

Epithelial basement membrane dystrophy (EBMD) is the most common corneal dystrophy, with an estimated prevalence of 5 %. However, it is often undiagnosed because it has nonspecific symptoms [1]. The pathogenesis of EBMD involves primary synthesis of an abnormal epithelial basement membrane with intraepithelial extensions. The absence of anchoring fibrils in patients with EBMD leads to a poorly adherent epithelium and increased risk for recurrent corneal erosion (RCE). It also increases risk of a perforated flap during cutting and of diffuse lamellar keratitis (DLK) [2].