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To assess the incidence of epithelial ingrowth after laser in situ keratomileusis and its correlation with myopic or hyperopic treatment.This retrospective study analyzed 1000 consecutive LASIK procedures performed by 3 surgeons using identical surgical technique with a Hansatome microkeratome. Eyes that developed epithelial ingrowth were evaluated using the Machat grading system. Patients were subdivided into 2 groups (myopic or hyperopic) based on the preoperative refractive error.The total incidence of epithelial ingrowth was 4.7%. The incidence after primary treatment was 3.9%. The incidence after enhancement was 12.8%. The total incidence of epithelial ingrowth was 3% in the myopic group compared with 23% in the hyperopic group. After primary myopic treatment, there was a 3% incidence of epithelial ingrowth compared with 17% after primary hyperopic treatment. The incidence after enhancement was 7% in the myopic group and 43% in the hyperopic group.Patients undergoing hyperopic laser in situ keratomileusis have a greater incidence of epithelial ingrowth than those undergoing myopic treatment. In addition, enhancement procedures have a higher incidence than primary procedures.